Efficacy and safety of Si-Jun-Zi-Tang-based therapies for functional (non-ulcer) dyspepsia: a meta-analysis of randomized controlled trials

Abstract

Background The traditional Chinese medicine formula Si-Jun-Zi-Tang (SJZT) has a long history of application in the treatment of functional dyspepsia (non-ulcer dyspepsia, FD)-like symptoms. SJZT-based therapies have been claimed to be beneficial in managing FD. This study aimed to assess the efficacy and safety of SJZT-based therapies in treating FD by meta-analysis. Methods Systematic searches for RCTs were conducted in seven databases (up to February 2019) without language restrictions. Data were analyzed using Cochrane RevMan software version 5.3.0 and Stata software version 13.1, and reported as relative risk (RR) or odds ratio (OR) with 95% confidence intervals (CIs). The primary outcome was response rate and the secondary outcomes were gastric emptying, quality of life, adverse effects and relapse rate. The quality of evidence was evaluated according to criteria from the Cochrane risk of bias. Results A total of 341 potentially relevant publications were identified, and 12 RCTs were eligible for inclusion. For the response rate, there was a statically significant benefit in favor of SJZT-based therapies (RR = 1.23; 95% CI 1.17 to 1.30). However, the benefit was limited to modified SJZT (MSJZT). The relapse rate of FD patients received SJZT-based therapies was lower than that of patients who received conventional medicines (OR = 0.23; 95% CI 0.10 to 0.51). No SJZT-based therapies-related adverse effect was reported. Conclusion SJZT-based prescriptions may be effective in treating FD and no serious side-effects were identified, but the effect on response rate appeared to be limited to MSJZT. The results should be interpreted with caution as all the included studies were considered at a high risk of bias. Standardized, large-scale and strictly designed RCTs are needed to further validate the benefits of SJZT-based therapies for FD management. Trial registration Systematic review registration: [PROSPERO registration: CRD42019139136].

Herbal therapies in functional dyspepsia: Do they really work?

“…Wang et al . have summarized the data from 12 randomized controlled trials on modified Si‐Jun‐Zi‐Tang, a common herbal product in China, and reported it to be effective in treating FD, while no serious side effects were identified 8 . Compared with western medicine, Rikkunshito (a herbal product widely used in Japan) was reported to achieve a better overall clinical efficacy rate, greater reduction of total dyspepsia symptom score, improved gastric emptying rate, and lower symptom recurrence at 6 months 9 .…”

Pharmacokinetics and metabolites of glycosides and lignans of the stem bark of Magnolia officinalis in functional dyspepsia and normal rats using liquid chromatography‐tandem mass spectrometry

“…Eradication of Helicobacter pylori , acid suppression therapy, prokinetics, and tricyclic antidepressants were usually used for treating FD, but none was proven to alter the long‐term natural history of FD [2]. In China, some traditional Chinese medicines (TCMs) have been used for the treatment of FD, for example, Si‐Jun‐Zi‐Tang and Houpo, the former has been proved to be efficacy and safe for improving the symptoms of FD by meta‐analysis of randomized controlled trials [3], and the latter one is the stem bark of Magnolia officinalis (MO), which involved in over 100 kinds of TCM formulae used clinically for the treatment of abdominal distention, FD, and constipation [4].…”

The Efficacy of The Herbal Formula of Bunium Persicum and Coriandrum Sativum on Clinical Symptoms of Patients with Functional Dyspepsia: A Double-Blind Randomized Controlled Trial

“…The multi-component formula of herbal medicine, as the most frequently used modality of CAM in FGID, can modify GI function with a wide variety of mechanisms that have not been fully clari ed (8,9) in Asian countries for various medicinal purposes including gastrointestinal (diarrhea, atulence) (10).…”