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Chinese herbal medicine effective in IBS
An Australian study recently published in the Journal of the
American Medical Association lends strong scientific support
to the traditional use of Chinese herbs in the treatment of irritable
bowel syndrome (IBS). The authors believe theirs is the first
clinical study to rigorously document the effectiveness of Chinese
herbal medicine in the treatment of IBS - and the first to incorporate
traditional Chinese diagnosis and treatment methods for IBS into
a strictly controlled, conventional study model [Bensoussan et
al., 1998].
The randomized, placebo-controlled, double-blind study involved
116 people with active IBS recruited from hospitals and private
gastroenterology practices in Sydney, Australia. Patients were
diagnosed first by gastroenterologists using standard western
diagnostic methods, and then by Chinese herbalists according to
the principles of Chinese medicine.
Forty-three subjects were randomized to receive a standard Chinese
herbal formula "considered to regulate and strengthen bowel function,"
38 took individualized herbal formulas, and 35 received a placebo
deemed to be indistinguishable from the herbal treatments. Treatments
were administered by capsule. Individualized treatments were custom-designed
by the Chinese herbalists, who also supervised treatment during
the course of the trial. Each subject worked with only one herbalist
for the duration of the study. Results were evaluated by gastroenterologists
after eight weeks and again at the end of the 16-week treatment
period.
Both the standard herbal formula and the individualized treatments
were significantly more effective than placebo in relieving IBS
symptoms. Not only did Chinese herbal therapy prove superior to
placebo, the researchers concluded that treatment benefits were
more sustained in patients who took individualized formulas than
in those who took the standard formula. Patients receiving the
herbal formulas had significantly better scores in four out of
five key outcome measures. Those taking the standard formula improved
by 44 percent (according to patient assessments) and 59 percent
(according to physician assessments) and those receiving individualized
treatments improved by 42 percent and 40 percent, compared to
22 percent and 19 percent improvements in subjects taking placebo.
The standard formula used in the trial, consisting of 20 Chinese
herbs, was not identified by name in the paper, nor were the individualized
formulas described. The herbs included in the highest proportions
in the standard formula were yin chen at 13 percent (Artemisia
capillaris Thunb., Asteraceae), bai zhu at 9 percent (Atractylodes
macrocephala Koidz., Asteraceae), dang shen at 7 percent (Codonopsis
pilosula [Franch.] Nannfeldt., Campanulaceae), yi yi ren (Job's
tears) at 7 percent (Coix lacryma-jobi L., Poaceae), and
wu wei zi (schizandra) at 7 percent (Schisandra chinensis
[Turcz.] Baill., Schisandraceae).
Two patients withdrew from the study because of adverse effects
related to the herbal treatment (gastrointestinal discomfort and
headache). No other major adverse effects were reported.
As many as 10 to 20 percent of Americans and Australians may
be afflicted with IBS, a chronic gastrointestinal disorder marked
by abdominal pain, bloating, and disturbances in bowel function
alternating from constipation to diarrhea. According to the authors
of the study, no single medical treatment provides reliable relief
or resolution of the condition. According to physician assessments
in this study, 78 percent of patients taking the standard Chinese
herbal formula and 50 percent of those receiving individualized
formulas improved during treatment, compared with 30 percent of
those taking placebo. - Evelyn Leigh (HRF)
[Bensoussan A, Talley NJ, Hing
M, Menzies R, Guo A, Ngu M. Treatment of irritable bowel syndrome
with Chinese herbal medicine. JAMA 1998; 280(18): 1585-1589.] |
