{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:14:33Z","timestamp":1753892073088,"version":"3.41.2"},"reference-count":56,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T00:00:00Z","timestamp":1748822400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders (FGIDs), characterized by complex pathogenesis, prolonged disease duration, frequent recurrence, and a significant impact on patients\u2019 quality of life. Si-Shen-Wan (SSW), a renowned traditional Chinese medicine formula, is widely recognized for its efficacy in managing gastrointestinal symptoms, particularly diarrhea, and is commonly used to treat diarrhea-predominant IBS (IBS-D). This study utilized a meta-analysis to evaluate the efficacy and safety of SSW in the treatment of IBS-D.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A comprehensive search for randomized controlled trials (RCTs) was conducted across seven databases from their inception to 31 October 2024. The analysis included outcomes such as efficacy rate, overall symptom score, abdominal pain score, diarrhea score, abdominal distension score, loss of appetite score, recurrence rate, and adverse events. Meta-analyses were performed using either a random-effects or fixed-effects model. Trial sequential analysis (TSA) was applied to estimate the sample size and validate the robustness of the meta-analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 34 RCTs involving 2,976 participants met the inclusion criteria. The findings demonstrated that SSW alone (RR = 1.28; 95% CI: 1.21, 1.34; P &amp;lt; 0.00001) or combined with biomedicine (RR = 1.26; 95% CI: 1.18, 1.35; P &amp;lt; 0.00001) significantly improved treatment efficacy compared to biomedicine alone. SSW also reduced the overall symptom score (SMD = \u22121.06; 95% CI: \u22121.50, \u22120.61; Z = 4.66; P &amp;lt; 0.00001) and alleviated key symptoms, including abdominal pain (MD = \u22120.66; 95% CI: \u22120.76, \u22120.56; Z = 12.99; P &amp;lt; 0.00001), diarrhea (MD = \u22120.69; 95% CI: \u22120.81, \u22120.56; Z = 10.82; P &amp;lt; 0.00001), abdominal distension (MD = \u22120.65; 95% CI: \u22121.06, \u22120.24; Z = 3.13; P = 0.002), and loss of appetite (MD = \u22120.55; 95% CI: \u22120.66, \u22120.44; Z = 9.80; P &amp;lt; 0.00001). The recurrence rate was also significantly reduced (RR = 0.40; 95% CI: 0.29, 0.55; P &amp;lt; 0.00001). Additionally, SSW combined with moxibustion\u2014a traditional Chinese medicine therapy integrating internal and external treatments\u2014also further improved treatment outcomes (RR = 1.22; 95% CI: 1.08, 1.37; P = 0.0001). This combination effectively reduced abdominal pain (MD = \u22120.42; 95% CI: \u22120.81, \u22120.04; Z = 2.17; P = 0.03), diarrhea (MD = \u22120.41; 95% CI: \u22120.64, \u22120.17; Z = 3.41; P = 0.0006), abdominal distension (MD = \u22120.40; 95% CI: \u22120.69, \u22120.11; Z = 2.67; P = 0.008), and loss of appetite (MD = \u22120.30; 95% CI: \u22120.49, \u22120.10; Z = 2.93; P = 0.003). Safety analysis revealed a high level of safety for SSW and SSW combined with moxibustion, with no serious adverse events reported in any of the included trials. TSA confirmed an adequate sample size for the primary outcome, supporting the efficacy of SSW in IBS-D treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>SSW, either used alone or combined with moxibustion, is effective in alleviating IBS-D symptoms and reducing recurrence rates, making it a potentially beneficial intervention. However, certain limitations remain in the overall quality of the current studies, including relatively small sample sizes, insufficiently long follow-up periods, and the absence of a double-blind design. Future research should emphasize the design and implementation of high-quality, long-term, randomized, double-blind clinical trials to further enhance the reliability and external applicability of the research findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Systematic Review Registration<\/jats:title><jats:p><jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/display_record.php?RecordID=597979<\/jats:ext-link>, identifier CRD42024597979.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fphar.2025.1534904","type":"journal-article","created":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T05:23:16Z","timestamp":1748841796000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and safety of Chinese botanical drug Si Shen Wan in irritable bowel syndrome: a meta-analysis and trial sequential analysis of randomized controlled trials"],"prefix":"10.3389","volume":"16","author":[{"given":"Qian","family":"Liu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zongming","family":"Shi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tao","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"SiJing","family":"Du","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yemei","family":"Gao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,6,2]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1016\/j.gtc.2010.12.013","article-title":"The effect of irritable bowel syndrome on health-related quality of life and health care expenditures","volume":"40","author":"Agarwal","year":"2011","journal-title":"Gastroenterology Clin. N. Am."},{"key":"B2","doi-asserted-by":"publisher","first-page":"408","DOI":"10.1186\/s12906-016-1386-4","article-title":"Moxibustion treatment for diarrhea-predominant irritable bowel syndrome: study protocol for a randomized controlled trial","volume":"16","author":"Bao","year":"2016","journal-title":"BMC Complement. Altern. Med."},{"volume-title":"To observe the clinical efficacy of shenlingbaizhu powder and sishenwan on treatment of spleen - kidney - Yang deficiency type\u2019s diarrhea [D]","year":"2017","author":"Bian","key":"B3"},{"key":"B4","doi-asserted-by":"publisher","first-page":"20","DOI":"10.3969\/j.issn.1005-1740.2019.04.004","article-title":"The effects and mechanism of berberine on irritable bowel syndrome induced by visceral hypersen-sitivity and abnormality in rats","volume":"29","author":"Chai","year":"2019","journal-title":"Chin. J. Microcirc."},{"key":"B5","doi-asserted-by":"publisher","first-page":"742","DOI":"10.3969\/j.issn.1671-038X.2018.09.07","article-title":"Influence of Tongxie Sishen decoction combined with trimebutine maleate and oryzanol on serum IFN-\u03b3,5-HT, NPY levels and T lymphocyte subsets in patients with diarrhea predominant irritable bowel syndrome","volume":"26","author":"Chen","year":"2018","journal-title":"Chin. J. Integr. Traditional West. Med. Dig."},{"key":"B6","doi-asserted-by":"publisher","first-page":"572","DOI":"10.16295\/j.cnki.0257-358x.2021.06.006","article-title":"Effect of sishen pill combined with du-moxibustion on diarrheal irritable bowel syndrome of spleen and kidney Yang deficiency type","volume":"40","author":"Chen","year":"2021","journal-title":"Shandong J. Traditional Chin. Med."},{"volume-title":"Clinical study of xiaoyao sishen decoction on treating liver stagnation spleen and kidney Yang deficiency syndrome of diarrhea-predominant irritable bowel syndrome","year":"2021","author":"Chen","key":"B7"},{"key":"B8","doi-asserted-by":"publisher","first-page":"48","DOI":"10.16254\/j.cnki.53-1120\/r.2017.06.023","article-title":"To observe the effect of Sishen pill combined with compound lactic acid bacteria capsule in the treatment of 45 cases of diarrhea-predominant irritable bowel syndrome","volume":"38","author":"Chen","year":"2017","journal-title":"Yunnan J. Traditional Chin. Med. Materia Medica"},{"key":"B9","doi-asserted-by":"publisher","first-page":"79","DOI":"10.13192\/j.ljtcm.2010.s1.81.chengzhsh.204","article-title":"Treatment of diarrhea-predominant irritable bowel syndrome with Sishen pills plus pinaverium bromide bifidobacterium triple viable bacteria","volume":"37","author":"Cheng","year":"2010","journal-title":"Liaoning J. Traditional Chin. Med."},{"key":"B10","doi-asserted-by":"publisher","first-page":"949","DOI":"10.1001\/jama.2015.0954","article-title":"Irritable bowel syndrome: a clinical review","volume":"313","author":"Chey","year":"2015","journal-title":"JAMA"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1257","DOI":"10.1053\/j.gastro.2016.03.035","article-title":"Rome IV-functional GI disorders: disorders of gut-brain interaction","volume":"150","author":"Drossman","year":"2016","journal-title":"Gastroenterology"},{"key":"B12","doi-asserted-by":"publisher","first-page":"16014","DOI":"10.1038\/nrdp.2016.14","article-title":"Irritable bowel syndrome","volume":"2","author":"Enck","year":"2016","journal-title":"Nat. Rev. Dis. Prim."},{"key":"B13","doi-asserted-by":"publisher","first-page":"80","DOI":"10.3969\/j.issn.1003-0174.2018.12.014","article-title":"Research on the \u03b2-sitosterol and stigmasterol therapeutic effect of acute colitis in mice","volume":"33","author":"Feng","year":"2018","journal-title":"J. Chin. Cereals Oils Assoc."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1026","DOI":"10.13359\/j.cnki.gzxbtcm.2018.06.015","article-title":"Clinical study of Chinese medicine combinced with moxibustion in treating diarrhea-predominant irritable bowel syndrome","volume":"35","author":"Fu","year":"2018","journal-title":"J. Guangzhou Univ. Traditional Chin. Med."},{"key":"B15","first-page":"85","article-title":"Clinical observation of using erjiang sishen decoction in the treatment of D-IBS","volume":"34","author":"Gu","year":"2016","journal-title":"J. Sichuan Traditional Chin. Med."},{"key":"B16","doi-asserted-by":"publisher","first-page":"261","DOI":"10.3969\/j.issn.1671-038X.2017.04.06","article-title":"Influence of Sishen decoction on VIP, SP and 5-HT3R levels of patients of diarrhea irritable bowel symptom with deficient kidney Yang","volume":"25","author":"He","year":"2017","journal-title":"Chin. J. Integr. Traditional West. Med. Dig."},{"key":"B17","doi-asserted-by":"publisher","first-page":"2022","DOI":"10.3969\/j.issn.1008-8849.2018.18.027","article-title":"Efficacy of Fuzi Lizhong decoction and Sishen pill in the treatment of diarrhea-predominant irritable bowel syndrome with spleen-kidney Yang deficiency and its influence on rectal mucosa protease-activated receptors","volume":"27","author":"Hou","year":"2018","journal-title":"Mod. J. Integr. Traditional Chin. West. Med."},{"key":"B18","doi-asserted-by":"publisher","first-page":"1472","DOI":"10.3969\/j.issn.1002-2619.2023.09.015","article-title":"The Curative effect of modified Sishen Pills plus Fuzi Lizhong Decoction for diarrhea-predominant irritable bowel syn-drome and its influence on intestinal flora","volume":"45","author":"Hu","year":"2023","journal-title":"Hebei J. Traditional Chin. Med."},{"key":"B19","doi-asserted-by":"publisher","first-page":"307","DOI":"10.3969\/j.issn.2095-1752.2016.01.272","article-title":"Clinical study on the administration of Shenlingbaizhu powder and Sishen pills for diarrheal irritable bowel syndrome","volume":"6","author":"Hu","year":"2016","journal-title":"J. Front. Med."},{"key":"B20","first-page":"170","article-title":"Analysis on the effect of Fuzi Lizhong Decoction combined with Sishen Wan in treating diarrheal irritable bowel syndrome of Spleen-kidney Yang deficiency type","volume":"25","author":"Hu","year":"2020","journal-title":"Health must-Read Mag."},{"key":"B21","doi-asserted-by":"publisher","first-page":"515","DOI":"10.3969\/j.issn.1003-8914.2018.04.029","article-title":"Clinical observation on modified wumei decoction combined with sishen pills in the treatment of irritable bowel syndrome of deficiency of the spleen and stomach","volume":"33","author":"Huang","year":"2018","journal-title":"Guangming J. Chin. Med."},{"key":"B22","doi-asserted-by":"publisher","first-page":"4372","DOI":"10.19435\/j.1672-1721.2016.31.029","article-title":"Analysis of curative effect of trimebutin maleate combined with Sishen pill in the treatment of irritable bowel syndrome","volume":"20","author":"Huang","year":"2016","journal-title":"Med. Forum"},{"key":"B23","doi-asserted-by":"publisher","first-page":"90","DOI":"10.13862\/j.cn43-1446\/r.2022.07.018","article-title":"Observation on the curative effect of du-moxibustion combined with sishen pill in the treatment of diarrhea type irritable bowel syndrome with spleen kidney Yang deficiency syndrome","volume":"29","author":"Li","year":"2022","journal-title":"Guid. J. Traditional Chin. Med. Pharmacol."},{"key":"B24","doi-asserted-by":"publisher","first-page":"3771","DOI":"10.3969\/j.issn.1003-8914.2019.24.033","article-title":"Clinical observation on sishen pill combined with jianpi pill on diarrhea with spleen deficiency and dampness","volume":"34","author":"Li","year":"2019","journal-title":"Guangming J. Chin. Med."},{"key":"B25","doi-asserted-by":"publisher","first-page":"10","DOI":"10.13422\/j.cnki.syfjx.20241207","article-title":"Sishenwan ameliorates visceral sensitivity in rat model of diarrhea-predominant irritable bowel syndrome (Spleen-kidney Yang deficiency) by regulating p38 MAPK\/JNK\/TRPV1 pathway","volume":"30","author":"Li","year":"2024","journal-title":"Chin. J. Exp. Traditional Med. Formulae"},{"key":"B26","doi-asserted-by":"publisher","first-page":"90","DOI":"10.3877\/j.issn.2095-8242.2018.A3.067","article-title":"Clinical study of Sishenlizhong Decoction in the treatment of diarrheal irritable bowel syndrome","volume":"5","author":"Li","year":"2018","journal-title":"J. Clin. Med. Literature Electron."},{"key":"B27","doi-asserted-by":"publisher","first-page":"71","DOI":"10.3969\/j.issn.1673-7202.2020.01.013","article-title":"Changes of gastrointestinal hormones in diarrhea predominant irritable bowel syndrome treated by tongxie sishen decoction and its clinical significance","volume":"15","author":"Liang","year":"2020","journal-title":"World Chin. Med."},{"key":"B28","doi-asserted-by":"publisher","first-page":"24","DOI":"10.13412\/j.cnki.zyyl.2019.03.005","article-title":"Experimental study on the effect of Sishen Wan (SSW) on intestinal barrier of IBS-D rats","volume":"35","author":"Liu","year":"2019","journal-title":"Pharmacol. Clin. Chin. Materia Medica"},{"key":"B29","first-page":"22","article-title":"A randomized parallel controlled study of Shugan Wenshen Decoction in the treatment of diarrheal irritable bowel syndrome [J]","volume":"27","author":"Liu","year":"2013","journal-title":"J. Pract. Traditional Chin. Intern. Med."},{"key":"B30","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":"B31","doi-asserted-by":"publisher","first-page":"1915","DOI":"10.13192\/j.issn.1000-1719.2019.09.038","article-title":"Clinical effect of fizi 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-\u03b1, IL-6 and IL-8","volume":"46","author":"Luo","year":"2019","journal-title":"Liaoning J. Traditional Chin. Med."},{"key":"B32","doi-asserted-by":"publisher","first-page":"755","DOI":"10.18553\/jmcp.2013.19.9.755","article-title":"A systematic review of the economic and humanistic burden of illness in irritable bowel syndrome and chronic constipation","volume":"19","author":"Nellesen","year":"2013","journal-title":"J. Manag. care Pharm. JMCP."},{"key":"B33","doi-asserted-by":"publisher","first-page":"23","DOI":"10.13729\/j.issn.1671-7813.2014.03.13","article-title":"A randomized parallel controlled study of Sishen granule in the treatment of Wugeng diarrhea","volume":"28","author":"Nie","year":"2014","journal-title":"J. Pract. Traditional Chin. Intern. Med."},{"key":"B34","doi-asserted-by":"publisher","first-page":"908","DOI":"10.1016\/S2468-1253(20)30217-X","article-title":"Global prevalence of irritable bowel syndrome according to Rome III or IV criteria: a systematic review and meta-analysis","volume":"5","author":"Priya","year":"2020","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"B35","doi-asserted-by":"publisher","first-page":"7","DOI":"10.3969\/j.issn.1674-7860.2022.22.002","article-title":"A study on the action mechanism of Sishen Wan on diarrhea irritable bowel syndrome based on network pharmacology and molecular docking","volume":"14","author":"Shen","year":"2022","journal-title":"Clin. J. Chin. Med."},{"key":"B36","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1053\/j.gastro.2019.04.019","article-title":"Cumulative effects of psychologic distress, visceral hypersensitivity, and abnormal transit on patient-reported outcomes in irritable bowel syndrome","volume":"157","author":"Simr\u00e9n","year":"2019","journal-title":"Gastroenterology"},{"key":"B37","doi-asserted-by":"publisher","first-page":"1075","DOI":"10.1136\/gutjnl-2015-311240","article-title":"The global prevalence of IBS in adults remains elusive due to the heterogeneity of studies: a Rome Foundation working team literature review","volume":"66","author":"Sperber","year":"2016","journal-title":"Gut"},{"volume-title":"Clinical observation of Fuzi Lizhong Decoction combined with Sishen Wan in the treatment of diarrhea type irritable bowel syndrome (Spleen-kidney Yang deficiency type)","year":"2023","author":"Sun","key":"B38"},{"key":"B39","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":"B40","doi-asserted-by":"publisher","first-page":"3174608","DOI":"10.1155\/2016\/3174608","article-title":"Study on the mechanism underlying the regulation of the NMDA receptor pathway in spinal dorsal horns of visceral hypersensitivity rats by moxibustion","volume":"2016","author":"Wang","year":"2016","journal-title":"Evidence-based complementary Altern. Med."},{"key":"B41","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1186\/s13020-018-0220-y","article-title":"Gut microbiota was modulated by moxibustion stimulation in rats with irritable bowel syndrome","volume":"13","author":"Wang","year":"2018","journal-title":"Chin. Med."},{"key":"B42","doi-asserted-by":"publisher","first-page":"3330","DOI":"10.3760\/cma.j.issn.1007-1245.2012.22.041","article-title":"Observation on curative effect of Shenling Baizhu Powder combined with Sishen Pill in treating diarrheal irritable bowel syndrome","volume":"18","author":"Wen","year":"2012","journal-title":"Int. Med. Health Guid. News"},{"key":"B43","doi-asserted-by":"publisher","first-page":"177","DOI":"10.13422\/j.cnki.syfjx.2016090177","article-title":"Treatment of fuzi lizhong tang plus sishen wan in treating diarrhea type irritable bowel syndrome with spleen and kidney deficiency syndrome","volume":"22","author":"Wen","year":"2016","journal-title":"Chin. J. Exp. Traditional Med. Formulae"},{"key":"B44","doi-asserted-by":"publisher","first-page":"64","DOI":"10.13729\/j.issn.1671-7813.Z20220497","article-title":"Observation of fuzi lizhong decoction and sishen pill on diarrhea irritable bowel syndrome","volume":"37","author":"Wu","year":"2023","journal-title":"J. Pract. Traditional Chin. Intern. Med."},{"volume-title":"Clinical application of Wuxing acupuncture and moxibustion in the treatment of diarrhea irritable bowel syndrome with spleen-kidney Yang deficiency","year":"2021","author":"Xiao","key":"B45"},{"key":"B46","first-page":"102","article-title":"Southern Song dynasty, 12th century","volume-title":"Pu Ji ben Shi Fang (revised edition)","author":"Xu","year":"2007"},{"key":"B47","doi-asserted-by":"publisher","first-page":"1822","DOI":"10.3969\/j.issn.1004-745X.2024.10.032","article-title":"Clinical observation of Shenling Baizhu Powder combined with Sishen Pill in treating diarrheal irritable bowel syndrome","volume":"33","author":"Xue","year":"2024","journal-title":"J. Emerg. Traditional Chin. Med."},{"key":"B48","doi-asserted-by":"publisher","first-page":"19","DOI":"10.3969\/j.issn.1009-3931.2009.04.010","article-title":"Treatment of 54 cases of diarrheal irritable bowel syndrome by adding Sishen pills","volume":"27","author":"Yang","year":"2009","journal-title":"Xinjiang J. Traditional Chin. Med."},{"key":"B49","doi-asserted-by":"publisher","first-page":"842","DOI":"10.3969\/j.issn.1000-7369.2015.07.038","article-title":"Observation on curative effect of Shenling Baizhu Powder combined with Sishen Pill in treating diarrheal irritable bowel syndrome","volume":"36","author":"Yang","year":"2015","journal-title":"Shaanxi J. Traditional Chin. Med."},{"key":"B50","doi-asserted-by":"publisher","first-page":"310","DOI":"10.16295\/j.cnki.0257-358x.2010.05.021","article-title":"Treatment of 62 cases of diarrheal irritable bowel syndrome with Sishen pills combined with Fuzi Lizhong pills","volume":"29","author":"Ye","year":"2010","journal-title":"Shandong J. Traditional Chin. Med."},{"key":"B51","doi-asserted-by":"publisher","first-page":"39","DOI":"10.16040\/j.cnki.cn15-1101.2022.09.069","article-title":"Clinical observation of Sishen pills combined with moxibustion on irritable bowel syndrome (diarrhea) of spleen-kidney Yang deficiency type","volume":"41","author":"Zhang","year":"2022","journal-title":"Nei Mongol J. Traditional Chin. Med."},{"key":"B52","doi-asserted-by":"publisher","first-page":"10450","DOI":"10.3748\/wjg.v22.i47.10450","article-title":"Economic burden of irritable bowel syndrome in China","volume":"22","author":"Zhang","year":"2017","journal-title":"World J. Gastroenterol."},{"key":"B53","first-page":"1156","article-title":"Analysis of the curative effect of Chinese and Western medicine in the treatment of diarrheal irritable bowel syndrome","author":"Zhang","year":"2021","journal-title":"J. Pract. Traditional Chin. Med."},{"key":"B54","first-page":"602","article-title":"Clinical observation of treating diarrheal irritable bowel syndrome with Chinese and Western medicine","volume":"36","author":"Zhao","year":"2020","journal-title":"J. Pract. Traditional Chin. Med."},{"key":"B55","doi-asserted-by":"publisher","first-page":"9410505","DOI":"10.1155\/2016\/9410505","article-title":"Comparison of electroacupuncture and moxibustion for relieving visceral hypersensitivity in rats with constipation-predominant irritable bowel syndrome","volume":"2016","author":"Zhao","year":"2016","journal-title":"Evidence-based complementary Altern. Med."},{"key":"B56","doi-asserted-by":"publisher","first-page":"500","DOI":"10.1186\/1472-6882-14-500","article-title":"Brain regions involved in moxibustion-induced analgesia in irritable bowel syndrome with diarrhea: a functional magnetic resonance imaging study","volume":"14","author":"Zhu","year":"2014","journal-title":"BMC Complement. Altern."}],"container-title":["Frontiers in Pharmacology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2025.1534904\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T05:23:42Z","timestamp":1748841822000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2025.1534904\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,2]]},"references-count":56,"alternative-id":["10.3389\/fphar.2025.1534904"],"URL":"https:\/\/doi.org\/10.3389\/fphar.2025.1534904","relation":{},"ISSN":["1663-9812"],"issn-type":[{"type":"electronic","value":"1663-9812"}],"subject":[],"published":{"date-parts":[[2025,6,2]]},"article-number":"1534904"}}