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Therap Adv Gastroenterol. 2018 Jul 16;11:1756284818785573. doi: 10.1177/1756284818785573. eCollection 2018.

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

Author information

1
Global Physician-Leadership Stream, MBChB program, The Chinese University of Hong Kong, Hong Kong.
2
Hong Kong Institute of Integrative Medicine, The Chinese University of Hong Kong, 5/F, School of Public Health Building, Prince of Wales Hospital, Shatin, New Territories, Hong Kong.
3
Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong.
4
Hong Kong Institute of Integrative Medicine, The Chinese University of Hong Kong, Hong Kong Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong.
5
China-Australia International Research Centre for Chinese Medicine School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney, Australia.
6
Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney, Australia Department of Family and Community Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
7
Hong Kong Institute of Integrative Medicine, The Chinese University of Hong Kong, Hong Kong.
8
Hong Kong Institute of Integrative Medicine, The Chinese University of Hong Kong, Hong Kong Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong.

Abstract

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.

KEYWORDS:

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

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