Chinese Herbal Medicines For Functional Dyspepsia

Objective:To evaluate the efficacy and safety of Chinese herbal medicines for functional dyspepsia (FD).Methods:We searched CENTRAL, PubMed, EMBASE, CBM, CNKI, Wanfang database, ISI Proceedings, ICTRP, ChiCTR from inception to December 2014 for randomized controlled trials (RCT) about Chinese herbal medicines for FD. Then, the outcomes of total effective rate, quality of life, gastric empty rate, relapse rate, and drug safety were measured. Data extraction and quality assessment were performed according to Cochrane systematic review handbook. Meta-analysis was carried out by RevMan 5.3 software. GRADE system was used to evaluate for the quality of evidence by GRADE profiler3.6 software.Results:60 RCTs with 5687 subjects were included. Our study found Chinese herbal medicines can increase the total effective rate of FD patients [RR=1.47,95%CI, (1.29,1.68), I2=0%] and the quality of life [WMD=37.87,95%CI (20.01,55.73), I2=44%] when compared with placebo.Moreover, the comparison of Chinese herbal medicines versus western medicines showed the better total efficiency of FD treatment [RR=1.15,95%CI (1.11,1.20), I2=47%], and recurrence rate [RR=0.34,95%CI (0.19,0.61), I2=39%]. The gastric empty rate and adverse drug reactions were RR=1.04,95% CI (0.84,1.29), I2=8%, and OR=0.83, 95%CI (0.43,1.61), I2=0%, respectively. Chinese herbal medicines combined with western medicines versus western medicines alone can also improve more total efficiency [RR=1.26,95%CI, (1.18,1.34), I2=19%] with the safety effect of OR=1.22,95%CI (0.30,4.89), I2=0%. All results and effect sizes measured by sensitivity analysis were stable. The publication bias was detected in the comparison between single Chinese medicine and western medicine, while the others were not identified by funnel plot test. Very low to medium quality of evidences were evaluated by GRADE system and the strength of recommendation was weak.Conclusion:Chinese herbal medicines for FD patients can improve the total efficiency, reduce the recurrence rate, show better gastric empty and not increase drug side effects when combined with western medicines.However, because of low quality of RCT, more high quality studies are required.