Efficacy of herbal treatments for functional dyspepsia: A systematic review and meta‐analysis of randomized clinical trials

Heiran, Alireza; Lankarani, Kamran Bagheri; Bradley, Ryan; Simab, Alireza; Pasalar, Mehdi

doi:10.1002/ptr.7333

Cited by 12 publications

(5 citation statements)

References 76 publications

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“…A previous meta-analysis of 29 RCTs suggested that prokinetic agents are more effective than placebo [RR = 0.81; 95% CI: (0.74, 0.89)] [ 48 ]. Eleven [ 28 , 30 – 34 , 37 , 39 , 40 , 42 , 43 ] out of the thirteen RCTs [ 28 , 30 – 34 , 37 , 39 – 44 ] included in this meta-analysis use prokinetics as a control condition, suggesting that the better TER of ZSXP than Western medicine was mainly driven by previous research reporting that herbal medicines have shown efficacy comparable to recognized drugs in treating FD [ 49 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of Zhishixiaopi decoction in functional dyspepsia: A meta-analysis of randomized controlled trials

Zhao,

Cheng,

et al. 2024

PLoS ONE

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Background Functional dyspepsia (FD) refers to a group of clinical symptoms caused by gastric and duodenal dysfunction. Which is a chronic functional disorder of the gastrointestinal tract with no cure. Zhishixiaopi decoction (ZSXP) is a type of Chinese herbal prescription that for treating FD. Although some randomized controlled trials (RCTs) report that ZSXP can significantly improve FD clinical symptoms and/or laboratory results, the trial design varies greatly among studies, making it challenging to draw a conclusion of the efficacy of ZSXP in treating FD. Design A systematic review and a meta-analysis. Setting Mianyang Central Hospital. Objective We conducted a systematic review and a meta-analysis to evaluate the efficacy and safety of ZSXP for treating FD. Methods We developed inclusion and exclusion criteria based on FD diagnosed criteria, interventions to treat FD, and outcomes of these interventions. Search strategies combined disease terms, symptom terms, anatomy terms and intervention terms. Literature search was conducted on eight online databases in English or Chinese, including Medline (via PubMed), Embase (via Ovid), The Cochrane Library, Web of Science, China Biology Medicine (CBM), China National Knowledge Infrastructure (CNKI), Chinese Scientific Journals Database (VIP), and Wanfang Database. Intervention The experimental group received oral administration of ZSXP and had a complete treatment process. ZSXP needs to fully contain the key herbal ingredients, regardless of whether the dosage of each herb is consistent with the original prescription. The Control group received monotherapy or combination therapy of other Western medicine and had a complete treatment process. Outcomes The primary outcomes appraised were Total effective rate (TER), serum levels of Motilin(MOT), Gastrin(GAS) and Somatostatin (SS), Gastric emptying rate (GER) using a Barium meal method (GER(B)) and Gastric half emptying time using an Ultrasonic method (GHET(T1/2)). The Cochrane Bias Risk Tool was used for quality critical appraisal, Review Manager (RevMan) version 5.3 was used for statistical analysis. Results A total of 21 medium-quality RCTs were included in the meta-analysis. All 21 included studies were conducted and completed in Mainland China from 1998 to 2020. The treatment duration was between two weeks to two months. The meta-analysis suggests that, compared with the Western medicine treatment group, ZSXP treatment was more effective to improving the TER in FD [Odds ratio, OR = 3.54, 95%CI:(2.49, 5.05), Z = 6.99, P<0.00001] without significant increase in adverse events. However, no statistical significance was found between the groups in serum MOT levels [Standard mean difference, SMD = 1.05, 95%CI:(-0.42, 2.53), Z = 1.04, P = 0.16], serum GAS levels [SMD = -0.16, 95%CI:(-1.20, 0.88), Z = 0.31, P = 0.76], serum SS levels [SMD = -0.04, 95%CI:(-1.97, 1.89), Z = 0.04, P = 0.97], GER(B) [SMD = 1.09, 95%CI:(-0.81, 3.00), Z = 1.12, P = 0.26]or GHET(T1/2) [Mean difference, MD = -2.18, 95%CI:(-5.55, 1.19), Z = 1.27, P = 0.20]. Conclusions The meta-analysis suggests that Zhishixiaopi treatment is a relatively effective and safe traditional Chinese medicine prescription and could be used for functional dyspepsia treatment. Considering the limitations of this study, the conclusion needs to be further confirmed by high-quality, multi-center, and large-sample randomized controlled trials.

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of Zhishixiaopi decoction in functional dyspepsia: A meta-analysis of randomized controlled trials

Zhao,

Cheng,

et al. 2024

PLoS ONE

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“…However, there is a lack of high-quality clinical evidence and there are more adverse events compared to placebo [ 35 , 36 ]. Limited evidence could support that psychotherapy is beneficial for patients with FD [ 37 ]. Herbal remedies might be effective and safe in treating FD and demonstrate comparable effect sizes for efficacy to conventional treatments, [ 38 ] Xiao Yao Pill and modified Ban Xia Xie Xin Decoction probably had great beneficial effect on ameliorating postprandial fullness [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Acupuncture Treatment for Postprandial Distress Syndrome: A Systematic Review and Meta-Analysis

Feng

Yuan

et al. 2022

Journal of Immunology Research

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Objective. This systematic review and meta-analysis was conducted to assess the efficacy of acupuncture treatment for postprandial distress syndrome (PDS). Methods. Search the Web of Science, the Cochrane Library, PubMed, and Embase databases with acupuncture randomized controlled trials for the treatment of patients with PDS. Strictly according to inclusion and exclusion quality assessment standards, the qualified ones are used to study the optimum extraction and data by two independent reviewers. Stata 15.0 software was used for meta-analysis. Result. We initially identified 63 studies, of which five (1253 participants) were eventually included in our analysis. There were 643 cases in the experimental group and 610 cases in the control group. Acupuncture had a significant effect on the total therapeutic effect (OTE) at week 4 (OR 4.74, 95% CI 02.88-7.83, Z = 6.10 , P = 0 < 0.05 ). Significantly improved NDI (Nepean dyspepsia index) scores of PDS patients at week 4 (SMD 0.61, 95% CI 0.48 to 0.74). Significantly improved NDI scores in PDS patients at week 16 (SMD 0.49, 95% CI 0.27 to 0.71). After acupuncture treatment, the SID (dyspepsia symptom index) score of PDS patients decreased significantly at week 4 (SMD-0.52, 95% CI -0.73 to -0.32) and week 16 (SMD-0.59, 95% CI -0.81 to -0.36). Postprandial satiety scores (SMD-0.63, 95% CI -0.76 to -0.50) and early satiety scores (SMD-0.51, 95% CI -0.64 to -0.37) were also significantly lower at week 4 after acupuncture. Conclusion. This study highlighted that the acupuncture could significantly improve the overall therapeutic effect of PDS patients, alleviate the symptoms of postprandial fullness and early satiety, and improve the quality of life of patients. Our results supported that acupuncture was an effective therapeutic strategy for postprandial distress syndrome.

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“…Herbal treatments show anti-inflammatory effects and contribute to an improvement in the function of gut microbiota, immune system, central stimuli, and intestinal motility in FD [ 16 ]. A systematic review and meta-analysis of 23 randomized controlled trials (RCTs) comparing the effectiveness of herbal treatments versus a placebo or other standard treatments for FD found that the majority of participants (>60%) in the herbal treatment group experienced an improvement in symptomatology and quality of life, compared to participants in the placebo group [ 17 ]. Chinese herbal medicines have been considered an effective alternative to prokinetics, according to a meta-analysis of 28 RCTs showing that Chinese herbal remedies were more effective than prokinetics at reducing the overall symptoms [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Food, Dietary Patterns, or Is Eating Behavior to Blame? Analyzing the Nutritional Aspects of Functional Dyspepsia

et al. 2023

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Functional dyspepsia is a gastrointestinal disorder characterized by postprandial fullness, early satiation, epigastric pain, and epigastric burning. The pathophysiology of the disease is not fully elucidated and there is no permanent cure, although some therapies (drugs or herbal remedies) try to reduce the symptoms. Diet plays a critical role in either the reduction or the exacerbation of functional dyspepsia symptoms; therefore dietary management is considered to be of high importance. Several foods have been suggested to be associated with worsening functional dyspepsia, such as fatty and spicy foods, soft drinks, and others, and other foods are thought to alleviate symptoms, such as apples, rice, bread, olive oil, yogurt, and others. Although an association between functional dyspepsia and irregular eating habits (abnormal meal frequency, skipping meals, late-night snacking, dining out, etc.) has been established, not many dietary patterns have been reported as potential factors that influence the severity of functional dyspepsia. A higher adherence to Western diets and a lower adherence to FODMAPs diets and healthy patterns, such as the Mediterranean diet, can contribute to the worsening of symptoms. More research is needed on the role of specific foods, dietary patterns, or specific eating habits in the management of functional dyspepsia.

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Efficacy of herbal treatments for functional dyspepsia: A systematic review and meta‐analysis of randomized clinical trials

Cited by 12 publications

References 76 publications

Efficacy and safety of Zhishixiaopi decoction in functional dyspepsia: A meta-analysis of randomized controlled trials

Efficacy and safety of Zhishixiaopi decoction in functional dyspepsia: A meta-analysis of randomized controlled trials

Efficacy of Acupuncture Treatment for Postprandial Distress Syndrome: A Systematic Review and Meta-Analysis

Food, Dietary Patterns, or Is Eating Behavior to Blame? Analyzing the Nutritional Aspects of Functional Dyspepsia

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