The Efficacy And Security Of Integrated Chinese And Western Medicine Therapy In Functional Dyspepsia:A Meta-analysis

Objective:To evaluate the efficacy and safety of integrated Chinese and Western medicine for functional dyspepsia.Methods:CNKI,Wangfang date,VIP,Pubmed、Embase、Cochrane Library were systematically searched for randomized contollde trails(RCT)about integrated Chinese and Western medicine for functional dyspepsia,during January 2009 to December 2017.Then the outcome of total effective tate,total symptom score,symptomatic score of epigastric pain,postprandial fullness,epigastric burning,early satiation,MTL,GAS,SS,NO,gastric empty rate,negative conversion of Helicobacter pylori infection,quality of life,phycological states,recurrence rate and safety were measured.Meta-analysis were perfomed according to RevMan 5.3 software,quality of provid assessment were carried out by GRADEprofiler software.Result:There are 29 RCTs with 3418 subjects were included,the study suggest that compared with Western medicine,the therapy combined Chinese with Western medicine is more effective among follows subject: total effecttive tate [P<0.00001,RR=1.22,95% CI =(1.19,1.26)],total effective rate for the therapy combined western medicine with Shugan Jieyu Capsule [P<0.00001,OR=4.56,95% CI =(2.45,8.466)],therapy combined western medicine with Xiangshaliujunzi dection [P<0.00001,OR=4.72,95% CI =(2.62,8.05)],total effective rate for the therapy combined western medicine with Banxiaxiexin dection [P=0.007,OR=3.79,95% CI =(1.44,10.01)],total symptom score[P=0.0002,MD=-3.17,95% CI =(-4.83,-1.52)],symptomatic score of epigastric pain[P<0.00001,MD=-0.77,95% CI =(-1.02,-0.52)],postprandial fullness[P<0.00001,MD=-0.74,95% CI=(-0.86;-0.62)],epigastric burning[P<0.00001,MD=-0.56,95% CI =(-0.74,-0.39)],early satiation[P=0.004,MD=-0.45,95% CI =(-0.75,-0.15)],MTL[P<0.00001,MD=55.12,95% CI =(38.76,71.48)],GAS[P=0.0005,MD=-3.73,95% CI =(-5.82,-1.65)],SS[P<0.0001,MD=-20.39,95% CI =(-30.6,-10.19)],NO[P<0.00001,MD=-8.99,95% CI =(-10.83,-7.15)],gastric empty rate[P<0.00001,MD=15.8,95% CI =(13.24,18.35)],negative conversion of Helicobacter pylori infection[P<0.00001,OR=3.68,95% CI =(1.64,8.28)],quality of life[P<0.00001,SMD=0.66,95% CI =(0.41,0.92)],depression perception scores [P<0.0001,SMD=-1.7,95% CI =(-2.52,-0.89)],and decrease recurrence rate [P<0.00001,OR=0.23,95% CI =(0.14,0.36)].The stress perception scores and safety wre [P=0.01,SMD=-1.91,95% CI=(-3.31,-2.08)],[P=0.17,OR=0.69,95% CI =(0.4,1.18)],respectively.Very low to medium quality of evidences were evaluated accoeding to GRADEProfiler based on GRADE systern,and were weak strength of recommendation.Conclusions : The treatment of Chinese herbal medicines plus conventional medicines group can improve the total efficiency,reduce the total symptom score,increase the level of MTL and GAS,decrease the level of SS and NO,show better negative conversion of Helicobacter pylori infection and gastric empty and lower recurrence rate,provide quality of life,and not increase the drug side effect.While,more high quality studies are necessary,because of the poor quality of RCTs which were include in the review.