Efficacy and Safety of Traditional Chinese Medicine on Nonerosive Reflux Disease: A Meta‐Analysis of Randomized Controlled Trials

Abstract

Objectives Traditional Chinese medicine (TCM) therapy for nonerosive reflux disease (NERD) remains controversial. The aim of this study was to evaluate the efficacy and safety of TCM regimens in NERD treatment. Methods Randomized controlled trials (RCTs) of TCM treatment for NERD through September 31, 2017, were systematically identified in PubMed, Wanfang Data, CNKI, VIP, CBM, Ovid, Web of Science, and Cochrane Library databases. Quality assessment was performed by employing the Cochrane Risk of Bias assessment tool. Results A total of 725 and 719 patients in 14 RCTs were randomly divided into TCM alone and conventional Western medicine groups, respectively. The clinical total effective rate of the TCM group was markedly higher than that of the single proton pump inhibitors (PPIs) or Prokinetics therapy group (RR = 1.19, 95% CI = 1.07–1.31, and P = 0.0008), while it was comparable to that of the combination of PPIs and Prokinetics therapy group (RR = 1.14, 95% CI = 1.00–1.29, and P = 0.05). Compared with Western medicine group, the TCM group showed improved symptom relief through a reduced RDQ score (SMD = −0.91; 95% CI = −1.68–−0.15; and P = 0.02). Additionally, TCM clearly decreased the recurrence rate (RR = 0.38, 95% CI = 0.28–0.52, and P < 0.00001). Adverse events, such as constipation, sickness, fever, abdominal distension, and stomach noise, were slight for both the TCM and Western medicine groups and disappeared after the easement of pharmacological intervention; in particular, TCM possessed fewer side effects. Conclusion Compared with PPIs or Prokinetics therapy alone, TCM single therapy can better improve the clinical total effective rate and symptom relief and decrease the recurrence rate and adverse events in the treatment of NERD. Our results suggest that TCM will be a promising alternative therapy for NERD patients in the future.

A Methodological and Reporting Quality Assessment of Systematic Reviews/Meta-Analyses about Chinese Medical Treatment for Gastroesophageal Reflux Disease

“…There were 28 reports [ 15 – 24 , 26 – 32 , 34 , 35 , 38 – 45 ] in Chinese and 5 reports [ 25 , 33 , 36 , 37 , 46 ] in English. 18 studies reported the sources of funding; but none of them were Cochrane reviews.…”

“…Methodological quality assessments with the OQAQ and AMSTAR 2 scale suggested that the results of the funding subgroups were similar. According to the PRISMA results, 28 reports [ 15 – 24 , 26 – 32 , 34 , 35 , 38 – 45 ] in Chinese had an average quality score of 19.2, and 5 reports [ 25 , 33 , 36 , 37 , 46 ] in English had an average quality score of 24. The 16 studies [ 17 , 20 , 22 , 24 , 26 – 29 , 31 , 33 , 35 , 37 , 40 – 45 ] that received funding had an average quality score of 19.6, and the nonfunded research had an average quality score of 20.2.…”

Efficacy of High Specific Volume Polysaccharide – A New Type of Dietary Fiber – On Molecular Mechanism of Intestinal Water Metabolism in Rats With Constipation

“…The important role of this membrane-penetrating aquaporin (AQP) is to help water molecules pass through the cell membrane rapidly [10]. It has been proven through experiments [11] that injecting vasoactive intestinal peptide (VIP) into rats with diarrhea increases the VIP expression in serum and intestinal tissues, and the protein expression of AQP is regulated by VIP activity, and the signal pathway of VIP/PKA/AQP in colon epithelial cells is affected, changing the molecular mechanism of intestinal water metabolism and causing the disappearance of diarrheal symptoms [8,12].…”

Efficacy of Chinese Herbal Formula Sini Zuojin Decoction in Treating Gastroesophageal Reflux Disease: Clinical Evidence and Potential Mechanisms

“…As a complementary and alternative medical treatment with fewer adverse effects and certain curative effects, the herbal formulae combined with fixed herbs are widely accepted and studied in China, Japan, South Korea, and other regions. In recent years, through the systematic review of reliable evidence, it has been found that classic TCM herbal formulae, such as Banxia Xiexin Decoction, Wendan Decoction, and others, can effectively improve GERD or some disorders of the gastrointestinal tract (Ling et al, 2015;Teschke et al, 2015;Tominaga and Arakawa, 2015;Dai et al, 2017;Xiao and Yang, 2018). Moreover, our team has collected 122 cases reported in the National Service Platform for Famous and Old Traditional Chinese Medicine (http://www.gjmlzy.com:83) and China National Knowledge Internet (http://www.cnki.net) via data mining based on using effect, flavor, meridian tropism, and syndrome differentiation to cluster analysis of tradition.…”