Efficacy and Safety of Modified Banxia Xiexin Decoction (Pinellia Decoction for Draining the Heart) for Gastroesophageal Reflux Disease in Adults: A Systematic Review and Meta-Analysis.

Yunkai Dai,Ling Hu,Danyan Li,Jintong Ye,Yunzhan Zhang,Weijing Chen

doi:10.1155/2017/9591319

Abstract

Modified Banxia Xiexin decoction (MBXD) is a classical Chinese herbal formula in treating gastroesophageal reflux disease (GERD) for long time, but the efficacy of it is still controversial. This study is to evaluate the efficacy and safety of MBXD for the treatment of GERD in adults. The search strategy was carried out for publications in seven electronic databases. RevMan software version 5.3 and the Cochrane Collaboration's risk of bias tool were performed for this review. Twelve RCTs were included for the analysis. The results of overall clinical efficacy and efficacy under gastroscope demonstrated that MBXD was superior to conventional western medicine. Meanwhile, the results of subgroup analysis showed clinical heterogeneity between the two groups. However, there was no statistically significant difference in acid regurgitation between the two groups. But in the improvement of heartburn and sternalgia, the results showed statistically significant differences for the comparison between two groups. In addition, the adverse reactions of the experiment groups were not different from those of the control groups. This systematic review indicates that MBXD may have potential effects on the treatment of patients with GERD. But because the evidence of methodological quality and sample sizes is weak, further standardized researches are required.

Highlights

Gastroesophageal reflux disease (GERD), which affects a substantial proportion of the world’s population in western countries, is defined as a gastroesophageal motility disorder that appears when the reflux of stomach contents causes troublesome gastroesophageal symptoms and/or complications [1]
Based on its clinical manifestation, GERD is subclassified into three types: nonerosive reflux disease (NERD), reflux esophagitis (RE), and Barrett esophagus (BE) [2]
As for classification of GERD, NERD was reported by 1 study [29], RE was reported by 7 studies [31, 35,36,37,38,39,40], and the remaining four studies [30, 32,33,34] did not Records identified through database searching PubMed = 36, Additional records identified SpringerLink = 0, EMBASE = 0, CNKI = 644, CBM = 458, through other sources (n = 0)

Summary

Introduction

Gastroesophageal reflux disease (GERD), which affects a substantial proportion of the world’s population in western countries, is defined as a gastroesophageal motility disorder that appears when the reflux of stomach contents causes troublesome gastroesophageal symptoms and/or complications [1]. Based on its clinical manifestation, GERD is subclassified into three types: nonerosive reflux disease (NERD), reflux esophagitis (RE), and Barrett esophagus (BE) [2]. The incidence of GERD appears to be an increasing problem throughout Asia including China, causing substantial reductions in subjective wellbeing [4] and lower work productivity and involving substantial healthcare costs [5]. To be better control of acid secretion, a substantial proportion of patients require twice-daily therapy with PPIs. In addition, decreasing transient lower esophageal sphincter relaxations (TLESRs) can reduce distal acid exposure and weakly acidic refluxate [6]. The long-term use of PPIs may cause some clinical risks, such as fracture [8,9,10], respiratory infection [11,12,13], spontaneous peritonitis [14], and clostridium difficile bacteria infection [15,16,17]

Results

Discussion

Conclusion