Chinese Classical Formula Sijunzi Decoction and Chronic Atrophic Gastritis: Evidence for Treatment Approach?

Abstract

Objective This aim is to evaluate the effect of Sijunzi decoction (SJZD) treating chronic atrophic gastritis (CAG). Methods We performed searches in seven databases. The randomized controlled trials (RCTs) comparing SJZD with standard medical care or inactive intervention for CAG were enrolled. Combined therapy of SJZD plus conventional therapies compared with conventional therapies alone was also retrieved. The primary outcome included the incidence of gastric cancer and the improvement of atrophy, intestinal metaplasia, and dysplasia based on the gastroscopy and pathology. The secondary outcomes were Helicobacter pylori clearance rate, quality of life, and adverse event/adverse drug reaction. Results Six RCTs met the inclusion criteria. The research quality was low in the trials. For the overall effect rate, pooled analysis from 4 trials showed that modified SJZD plus conventional medications exhibited a significant improvement (OR = 4.86; 95% CI: 2.80 to 8.44; P < 0.00001) and without significant heterogeneity compared with the conventional medications alone. None reported the adverse effect. Conclusions Modified SJZD combined with conventional western medicines appears to have benefits for CAG. Due to the limited number and methodological flaw, the beneficial and harmful effects of SJZD for CAG could not be identified. More high-quality clinical trials are needed to confirm the results.

A Systematic Review of the Mechanisms Underlying Treatment of Gastric Precancerous Lesions by Traditional Chinese Medicine

“…Sijunzi decoction, a traditional Chinese herbal formula, has been widely used to treat gastrointestinal disorders. Several meta-analyses demonstrated that Sijunzi decoction was efficacious and safe for atrophy chronic gastritis and gastric cancer [24,30]. Clinical studies have shown that Sijunzi decoction or modified Sijunzi decoction can reverse pathological gastric changes (including chronic atrophic gastritis, intestinal metaplasia, and gastric epithelial dysplasia) and is effective in treating patients with fatigue and tiredness [24][25][26]31].…”

“…Several meta-analyses demonstrated that Sijunzi decoction was efficacious and safe for atrophy chronic gastritis and gastric cancer [24,30]. Clinical studies have shown that Sijunzi decoction or modified Sijunzi decoction can reverse pathological gastric changes (including chronic atrophic gastritis, intestinal metaplasia, and gastric epithelial dysplasia) and is effective in treating patients with fatigue and tiredness [24][25][26]31]. Weiansan, a classical formula commonly used in the treatment of GPL, was found to have definite effects, including suppression of glandular atrophy, intestinal metaplasia, and dysplasia and elimination of H. pylori [17].…”

The Mechanisms of Sijunzi Decoction in the Treatment of Chronic Gastritis Revealed by Network Pharmacology

“…It was used to treat various digestive diseases such as gastritis, duodenitis, and inflammatory bowel disease [ 8 ]. As for chronic gastritis, researchers have conducted some clinical trials to investigate the effects of Sijunzi decoction [ 9 ]. Tian et al found that modified Sijunzi decoction could alleviate the symptoms of chronic atrophic gastritis such as fatigue and tiredness [ 10 ].…”

“…Tian et al found that modified Sijunzi decoction could alleviate the symptoms of chronic atrophic gastritis such as fatigue and tiredness [ 10 ]. Gan et al enrolled 6 randomized controlled trials to conduct meta-analysis and demonstrated that Sijunzi decoction was beneficial to chronic atrophic gastritis patients [ 9 ]. However, they have not revealed the mechanism of Sijunzi decoction in the treatment of chronic gastritis.…”

Confirming the Effects of Qinghuayin against Chronic Atrophic Gastritis and a Preliminary Observation of the Involved Inflammatory Signaling Pathways: An In Vivo Study

“…In China, many therapies based on the theories of traditional Chinese medicine (TCM) have been considered. A recent systemic review has suggested that a Chinese classical formula, Sijunzi decoction, may benefit CAG patients [ 3 ]. In addition to Sijunzi decoction, Qinghuayin (QHY) is another Chinese formula that is widely used in the treatment of CAG based on the TCM theories of clearing heat and resolving dampness.…”