Efficacy of Chinese Herbal Medicine for Diarrhea‐Predominant Irritable Bowel Syndrome: A Meta‐Analysis of Randomized, Double‐Blind, Placebo‐Controlled Trials

<jats:p><jats:italic>Objective</jats:italic>. To explore the efficacy of Chinese herbal medicine in treating diarrhea‐predominant irritable bowel syndrome (D‐IBS). <jats:italic>Methods</jats:italic>. Four English and four Chinese databases were searched through November, 2015. Randomized, double‐blind and placebo‐controlled trials were selected. Data extraction and quality evaluation were performed by two authors independently. RevMan 5.2.0 software was applied to analyze the data of included trials. <jats:italic>Results</jats:italic>. A total of 14 trials involving 1551 patients were included. Meta‐analysis demonstrated superior global symptom improvement (RR = 1.62; 95% CI 1.31, 2.00; <jats:italic>P</jats:italic> < 0.00001; number needed to treat = 3.6), abdominal pain improvement (RR = 1.95; 95% CI 1.61, 2.35; <jats:italic>P</jats:italic> < 0.00001), diarrhea improvement (RR = 1.87; 95% CI 1.60, 2.20; <jats:italic>P</jats:italic> < 0.00001), pain threshold assessment (MD = 54.53; 95% CI 38.76, 70.30; <jats:italic>P</jats:italic> < 0.00001), and lower IBS Symptom Severity Score (SMD = −1.01; 95% CI −1.72, −0.30; <jats:italic>P</jats:italic> = 0.005), when compared with placebo, while for defecation threshold assessment, quality of life, and adverse events, no differences were found between treatment groups and controlled groups. <jats:italic>Conclusion</jats:italic>. This meta‐analysis shows that Chinese herbal medicine is an effective and safe treatment for D‐IBS. However, due to the small sample size and high heterogeneity, further studies are required.</jats:p>