Table 1.
Randomized trial of herbal supplement therapies in functional dyspepsia (FD) patients.
| Herbal supplement | n. | Type of study | Treatment response rate | Placebo response rate | Conventional therapy response rate | p value | Outcome measures | Ref. | Proposed mechanisms of action |
|---|---|---|---|---|---|---|---|---|---|
| Dried banana powder | 46 | Randomized trial over standard care | 75% | – | 20% | p < 0.05 | Symptom improvement | 9 | Antiulcerogenic activity |
| Promotes gastric mucus secretion | |||||||||
| Curcuma Longa | 116 | Randomized, double-blind, multicenter trial over placebo | 87% | 53% | – | p = 0.003 | Symptom improvement | 10 | Increased biliary secretion |
| Spasmolytic action | |||||||||
| Ginger | 11 | Randomized, double-blind, trial over placebo | No difference over placebo | p = NS | Gastric emptying rates | 22 | Increased gastric emptying rate, no effects on gut hormonesb | ||
| Mentha piperita and Carum carvi | 96 | Randomized, controlled trial | 40% | 22% | – | p < 0.05 | Intensity of epigastric pain | 15 | Choleretic and antimeteoric action |
| Capsicum annuum | 30 | Randomized, controlled trial | 60% | 30% | – | p < 0.05 | Symptom improvement | 19 | Reduced gastric visceral nociception via desensitization of C-type neural fibers |
| Cynara scolymus | 247 | Randomized, double-blind, multicenter trial over placebo | a | a | – | p < 0.001 | Overall change in dyspeptic symptoms and QoL (Nepean Dyspepsia Index) | 26 | Increased bile flow and exerts hepatoprotective, antioxidant and antispasmodic effects |
| Iberogast | 315 | Randomized, double-blind, placebo-controlled | a | a | No differences against herbal therapy group | p < 0.05 | GIS | 27–32 | Modulation of gastric sensorimotor function, nociception, bile clearance and gastric acid clearanceb |
| Rikkunshito | 247 | Randomized, double-blind, multicenter trial over placebo | 33.6% | 23.8% | – | p = 0.04 | Global Patient Assessment (GPA) | 39–41 | Acceleration of gastric emptying by increasing ghrelin plasma concentrationc |
| Potential modulation of visceral afferents |
a
Results expressed as change in symptoms from baseline rather than response rate, by intention-to-treat analysis. bNo relationship between symptom improvement and acceleration of gastric emptying could be demonstrated in vivo. cIn animals, not confirmed in humans.
QoL: quality of life; GIS: gastrointestinal symptom score.