Table 3.
Chinese herbal medicine for functional dyspepsia: systematic review of meta-analysis results.
| Author(s) | Studies, n (patients, n) | Comparison* | Pooled results (95% CI) | Heterogeneity I2 (%) |
|---|---|---|---|---|
| Alleviation of global dyspeptic symptoms | ||||
| Liu et al.38** | 4 (309) | CHM versus prokinetic agents | RR: 1.02 (0.90, 1.15) | 62$ |
| Qin et al.31 | 5 (649) | Modified Xiao Yao San versus pharmacotherapy | OR: 3.53 (2.32, 5.36) | 0 |
| Cui29 | 23 (2013) | CHM versus domperidone | RR: 1.20 (1.15, 1.25) | 14 |
| Cui and Shen29 | 16 (1533) | CHM versus mosapride | RR: 1.14 (1.06, 1.24) | 62$ |
| Wang et al.30 | 12 (1069) | CHM versus pharmacotherapy | OR: 3.20 (2.27, 4.51) | 0 |
| Wang et al.30 | 2 (120) | CHM versus mosapride | OR: 3.98 (1.50, 10.54) | 0 |
| Wang et al.30 | 8 (663) | CHM versus domperidone | OR: 2.99 (1.93, 4.63) | 0 |
| Xiao et al.32 | 3 (350) | Liu Jun Zi decoction versus prokinetic agents | OR: 1.99 (0.71, 5.60) | 63$ |
| Xiao et al.33 | 7 (507) | Xiang Sha Liu Jun Zi decoction versus prokinetic agents | OR: 3.29 (1.99, 5.43) | 0 |
| Yang et al.34 | 8 (728) | Modified Chai Hu Shu Gan powder versus pharmacotherapy | RR: 1.22 (1.13, 1.32) | 0 |
| Gan et al.35 | 9 (872) | Ban Xia Xie Xin decoction versus prokinetic agents | OR: 2.58 (1.72, 3.85) | 0 |
| Fan and He36‡ | 9 (907) | Da Li Tong granule versus prokinetic agents | OR: 1.17 (0.88, 1.55) | 0 |
| Liu25 | 37 (3339) | CHM versus pharmacotherapy | RR: 1.15 (1.10, 1.20) | 52$ |
| Zhang27 | 20 (1998) | CHM versus pharmacotherapy | OR: 3.73 (2.85, 4.88) | 0 |
| Akarayosapong37 | 9 (786) | Liu Wei An Xiao capsule versus pharmacotherapy | RR: 1.29 (1.12, 1.49) | 76$ |
| Ling et al.28 | 27 (2793) | Si Ni San versus pharmacotherapy | OR: 3.81 (3.05, 4.77) | 0 |
| Qin et al.31 | 6 (423) | Modified Xiao Yao San +
pharmacotherapy versus pharmacotherapy |
OR: 4.71 (2.69, 8.25) | 0 |
| Xiao et al.33 | 9 (918) | Shu Gan Jie Yu + mosapride versus mosapride | OR: 3.57 (2.53, 5.05) | 0 |
| Yang et al.34 | 6 (470) | Modified Chai Hu Shu Gan powder + pharmacotherapy versus pharmacotherapy | RR: 1.15 (1.07, 1.23) | 0 |
| Liu25 | 8 (827) | CHM + pharmacotherapy versus pharmacotherapy | RR: 1.23 (1.14, 1.34) | 28 |
| Akarayosapong37 | 5 (681) | Liu Wei An Xiao capsule + pharmacotherapy versus pharmacotherapy | RR: 1.22 (1.14, 1.32) | 0 |
| Liu25 | 4 (459) | CHM versus placebo | RR: 1.47 (1.29, 1.68) | 0 |
| Guo et al.26 | 7 (1074) | CHM versus placebo | RR: 1.45 (1.31, 1.60) | 8 |
| Alleviation of individual dyspeptic symptoms** | ||||
| (a) Alleviation of fullness sensation | ||||
| Liu et al.38 | 1 (55) | CHM versus domperidone | RR: 1.07 (0.93, 1.24) | NA |
| (b) Gastric emptying# | ||||
| Liu25 | 1 (16) | CHM versus pharmacotherapy | RR: 0.80 (0.33, 1.92) | NA |
| Akarayosapong37 | 4 (357) | Liu Wei An Xiao capsule versus prokinetic agents | MD: 2.16 (0.26, 4.17) | 4 |
| (c) Alleviation of epigastric pain** | ||||
| Akarayosapong37 | 6 (NR) | Liu Wei An Xiao capsule versus pharmacotherapy | RR: 1.18 (1.06, 1.31) | 28 |
| (d) Alleviation of epigastric burning** | ||||
| Akarayosapong37 | 3 (NR) | Liu Wei An Xiao capsule versus pharmacotherapy | RR: 0.98 (0.76, 1.26) | 0 |
| (e) Alleviation of postprandial fullness** | ||||
| Akarayosapong37 | 3 (NR) | Liu Wei An Xiao capsule versus pharmacotherapy | RR: 1.06 (0.97, 1.16) | 46 |
| (f) Alleviation of early satiety** | ||||
| Akarayosapong37 | 5 (NR) | Liu Wei An Xiao capsule versus pharmacotherapy | RR: 1.17 (1.04, 1.32) | 18 |
| Quality of life | ||||
| Liu25‖ | 3 (367) | CHM versus placebo | MD: 37.87 (20.01, 55.73) | 44 |
| Guo et al.26‖ | 6 (698) | CHM versus placebo | SMD: 0.30 (0.15, 0.45) | 0 |
| Liu25‖ | 5 (387) | CHM versus pharmacotherapy | MD: 4.82 (2.13, 7.50) | 98$ |
| Alleviation of Chinese medicine syndrome‡‡ | ||||
| Guo et al.26 | 5 (741) | CHM versus placebo | RR: 1.36 (1.23, 1.50) | 31 |
| Plasma acylated ghrelin level | ||||
| Xiao et al.32 | 1 (27) | Liu Jun Zi Tang versus domperidone | MD: 9.00 (−0.27, 18.27) | NA |
| ‘Obviously effective’ rate‡ | ||||
| Fan and He36 | 9 (907) | Da Li Tong granule versus prokinetic agents | OR: 1.38 (0.90, 2.11) | 0 |
| Safety¶ | ||||
| Liu25 | 9 (761) | CHM versus pharmacotherapy | OR: 0.98 (0.45, 2.12) | 0 |
| Zhang27 | 4 (388) | CHM versus pharmacotherapy | OR: 0.14 (0.03, 0.63) | 0 |
| Akarayosapong37 | 6 (425) | Liu Wei An Xiao capsule versus pharmacotherapy | OR: 1.11 (0.38, 3.23) | 0 |
| Liu25 | 2 (222) | CHM + pharmacotherapy versus pharmacotherapy | OR: 1.22 (0.30, 4.89) | 0 |
| Guo et al.26 | 4 (771) | CHM versus placebo | RR: 1.06 (0.66, 1.70) | 0 |
CHM denotes the inclusion of multiple types of Chinese herbal medicine. The generic term ‘prokinetic agents’ is used to denote that multiple types of prokinetic agents were included in the comparison. The term ‘pharmacotherapy’ was used when both proton pump inhibitor and prokinetic agents were included in the comparison. If the authors evaluated multiple CHM formulations and provided detailed information, we reported the compositions of herbal formulations in Table A3 in the appendix.
Alleviation of global or individual dyspeptic symptoms is measured by Gastrointestinal Symptom Rating Scale (GSRS) or other standardized scales. GSRS is a score in which patients report dyspeptic symptom severity on a four-point Likert scale (symptom free, marked improvement, slight improvement, and no improvement).
p < 0.10 for the heterogeneity test.
‘Obviously effective’ rate denotes a numerical result ⩾ 60% in the following calculation: [(Severity score of symptoms before treatment – Severity score of symptoms after treatment) / Severity score of symptoms before treatment] × 100%, with symptoms measured by the GSRS and other standardized scales.
Quality of life is measured with the 36-Item Short Form Survey (SF-36).
Quality of life is measured with the 36-Item Short Form Survey (SF-36), Quality of Life Questionnaire for Functional Digestive Disorders, Functional Dyspepsia-Related Quality of Life or other validated scales.
Safety denotes the occurrence of any side effects or adversities due to the use of interventions or placebo. This definition applies to all results under the ‘Safety’ section in Table 3.
Gastric emptying rate is defined as the GSRS scores in emptying the stomach25 and as the percentage of substances remaining in stomach 4–5 h after a meal.37
Alleviation of Chinese medicine syndrome measures symptom improvement according to traditional Chinese medical theories and standards.
CHM, Chinese herbal medicine; CI, confidence interval; RR, risk ratio; OR, odds ratio; MD, mean difference; SMD, standard mean difference; NA, not applicable.