Background Banxia Xiexin decoction (BXD), a classical formula of traditional Chinese medicine (TCM), has been wildly used for chronic atrophic gastritis (CAG) patients with the cold-heat complex syndrome in China, and achieved satisfied effects. However, the clinical effects of it remains unclear. Purpose The purpose of this article is to evaluate the clinical efficacy and safety of BXD for CAG treatment. Methods We searched seven electronic databases including Ovid, Embase, PubMed, Cochrane Library, Wan-fang database, VIP (Chinese Scientific Journals Database) and CNKI (China National Knowledge Infrastructure) from their inception to September 21, 2020. We used Jadad scale and Cochrane Collaboration’s risk of bias tool to make evaluation of methodological quality. Revman 5.3 statistical software was used for statistical processing to evaluate the clinical efficacy and safety of BXD. Results 26 randomized controlled trials (RCTs) totaling 1985 patients were identified for analysis. Meta-analysis showed that BXD treatment was more effective (RR 1.29; 95%CI 1.24, 1.35; P<0.00001) and safe (MD 0.33; 95%CI 0.18, 0.58; P = 0.0002) than Chinese patent medicine + western medicine. Furthermore, BXD had improvement on symptoms scores such as stomach distending pain, and belching. Besides, BXD was more effective in inhibiting Helicobacter Pylori (HP), improving HP-related inflammation, and relieving the degree of glandular atrophy, intestinal metaplasia (IM), and dysplasia of gastric mucosa (GM). Conclusions The meta-analysis showed that BXD was more effective and safer for CAG patients than the control group. However, due to limitations of methodological quality and small sample size of the included studies, further standardized research of rigorous design should be needed.

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Objective: Shugan Hewei therapy (SHT) acts to soothe the liver and harmonize the stomach. It is a classical traditional Chinese medicine method widely used in China to treat chronic atrophic gastritis (CAG) due to liver qi invading the stomach. However, the clinical effects of SHT remain unclear. We aimed to evaluate the overall clinical effective rate and safety of SHT in treating CAG.Methods: We used the Jadad scale and Cochrane Collaboration risk of bias tool to evaluate the methodological quality of studies investigating SHT. Eight medical databases were searched to identify relevant studies. After data extraction and quality evaluation, 27 randomized controlled trials, including 2,441 patients, were considered eligible for analysis. No serious heterogeneity or publication bias was observed across the included studies. We used Revman 5.3 statistical software to evaluate the general clinical effective rate and safety of SHT.Results: The results showed that SHT was more effective (RR=1.25; 95% CI [1.20, 1.29]; P<0.01) and safer (MD=0.24, 95% CI [0.08, 0.75]; P<0.01) than control interventions comprising western medicine, Chinese patent medicine, and/or western medicine + Chinese patent medicine. Compared with the control interventions, SHT resulted in greater improvements in the symptom scores for stomach distension and stomachache, serum gastrin level, histopathologic changes, Helicobacter pylori (HP) inhibition rate, and gastric mucosal inflammation. Conclusion: SHT was more effective and safer than control interventions for CAG.

BackgroundChronic atrophic gastritis (CAG), premalignant lesions of gastric cancer (GC), greatly increases the risk of GC. Gastroscopy with tissue biopsy is the most commonly used technology for CAG diagnosis. However, due to the invasive nature, both ordinary gastroscope and painless gastroscope result in a certain degree of injury to the esophagus as well as inducing psychological pressure on patients. In addition, patients need fast for at least half a day and take laxatives.MethodsIn this study, fecal metabolites and microbiota profiles were detected by metabolomics and 16S rRNA V4-V5 region sequencing.ResultsAlteration of fecal metabolites and microbiota profiles was found in CAG patients, compared with healthy volunteers. To identify the most relevant features, 7 fecal metabolites and 4 microbiota were selected by random forest (RF), from A and B sample sets, respectively. Furthermore, we constructed support vector machines (SVM) classifification model using 7 fecal metabolites or 4 gut microbes, or 7 fecal metabolites with 4 gut microbes, respectively, on C sample set. The accuracy of classifification model was 0.714, 0.857, 0.857, respectively, and the AUC was 0.71, 0.88, 0.9, respectively. In C sample set, Spearman’s rank correlation analysis demonstrated heptadecanoic acid and pentadecanoic acid were signifificantly negatively correlated to Erysipelotrichaceae_UCG-003 and Haemophilus, respectively. We constructed SVM classifification model using 2 correlated fecal metabolites and 2 correlated gut microbes on C sample set. The accuracy of classification model was 0.857, and the AUC was 0.88.ConclusionTherefore, heptadecanoic acid and pentadecanoic acid, crosstalk with fecal-derived gut microbiota namely Erysipelotrichaceae_UCG-003 and Haemophilus, are potential non-invasive biomarkers for CAG diagnosis.