Objective:To critically evaluate and summarize the methodological quality of systematic reviews(SRs)and present objective and important outcomes on the effectiveness of traditional Chinese medicine(TCM)therapies,including Chinese herbal medicine(CHM),acupuncture,and moxibustion,for diarrhea-predominant irritable bowel syndrome(IBS-D).Methods:We conducted a comprehensive literature search for SRs in 7 databases until April 16,2022.Two reviewers independently extracted data and assessed the methodological quality of the reviews according to the Assessing the Methodological Quality of Systematic Reviews 2(AMSTAR-2),the Risk of Bias in Systematic reviews(ROBIS)tool,and the Preferred Reporting Item for Systematic Review and Meta-analysis(PRISMA)statement.The Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)was used to rate the quality of evidence.Results:IBS-D patients included in 12 reviews were diagnosed in accordance with the Rome criteria,9 reviews focused on CHM,2 articles observed moxibustion and heat-sensitive moxibustion,1 article studied acupuncture and CHM.The outcomes of the SRs were the effectiveness rate,the total effectiveness rate,global symptom improvement,and adverse effects.Based on AMSTAR-2,which measures the quality of methodology,all of the included studies were of low or critically low quality.According to the ROBIS tool,10 SRs(83.33％)had a high risk of bias.With the PRISMA checklist,only 3 SRs reached over 90％compliance.Based on GRADE,most evidence was of low quality,and there was a moderate quality of evidence that the effectiveness rate of modified-Tongxie Yaofang was superior to Western medicine in the treatment of IBS-D.Conclusion:Given the suboptimal reporting and methodological quality of existing SRs,more studies are needed to clarify whether TCM therapies are more effective or safe than pharmacological medicine.Future studies should combine evidence-based medicine with TCM research according to the charac-teristics of TCM.

Jun Zhao;Xia Li;Xiaowei Chen;Hui Zheng;Kun Ye;Yunzhou Shi;Xin Xie;Jianfang Wang;Min Chen;Zhigang Li

School of Acupuncture,Moxibustion and Tuina,Beijing University of Chinese Medicine,Beijing,102488,China;Department of Spleen,Stomach,Liver and Gallbladder Diseases,Dongfang Hospital Affiliated to Beijing University of Chinese Medicine,Beijing,100078,China;The Third Hospital/Acupuncture and Tuina School,Chengdu University of Traditional Chinese Medicine,Chengdu,610075,China;Anorectal Disease Department,Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu,610072,China

中医科学杂志（英文）

[1]Jun Zhao;Xia Li;Xiaowei Chen;Hui Zheng;Kun Ye;Yunzhou Shi;Xin Xie;Jianfang Wang;Min Chen;Zhigang Li-.Common traditional Chinese medicine therapies for diarrhea-predominant irritable bowel syndrome:An overview of systematic reviews)[J].中医科学杂志（英文）,2022(03):330-339

Tongxie,Yaofang

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