KMCRIC

Chinese herbal medicine for functional dyspepsia: systematic review of systematic reviews.

Chu MHK, Wu IXY, Ho RST, Wong CHL, Zhang AL, Zhang Y, Wu JCY, Chung VCH.

Therap Adv Gastroenterol.

2018

11

1756284818785573.

10.1177/1756284818785573.

30034530

http://www.ncbi.nlm.nih.gov/pubmed/30034530

functional dyspepsia; Chinese herbal medicine; Chinese herbs; prokinetics; proton pump inhibitors; systematic reviews

기능성 소화불량; 중약학; 중약; 위장관 운동 촉진제; 프로톤 펌프 억제제; 체계적 문헌고찰

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Background:
Pharmacotherapy, including prokinetics and proton pump inhibitors for functional dyspepsia (FD) have limited effectiveness, and their safety has been recently questioned. Chinese herbal medicine (CHM) could be considered as an alternative. A systematic review (SR) of SRs was performed to evaluate the potential effectiveness and safety of CHM.

Method:
We conducted a comprehensive literature search for SRs with meta-analyses in eight international and Chinese databases. Pooled effect estimation from each meta-analysis was extracted. The AMSTAR instrument was used to assess the methodological quality of the included SRs.

Results:
A total of 14 SRs of mediocre quality assessing various CHMs, alone or in combination with conventional pharmacotherapy, were included. Meta-analyses showed that CHM was more effective than prokinetic agents for the alleviation of global dyspeptic symptoms. Three specific CHM formulae appeared to show superior results in the alleviation of global dyspeptic symptoms, including Si Ni San, modified Xiao Yao San and Xiang Sha Liu Jun Zi decoction. No significant difference in the occurrence of adverse events in using CHM or pharmacotherapy was reported.

Conclusion:
CHM can be considered as an alternative for the treatment of FD symptoms when prokinetic agents and proton pump inhibitors are contraindicated. Future trial design should focus on measuring changes in individual dyspeptic symptoms and differentiate the effectiveness of different CHM for postprandial distress syndrome and epigastric pain syndrome. A network meta-analysis approach should be used to explore the most promising CHM formula for FD treatment in the future.

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