Traditional Chinese medicine compounds for the treatment of functional dyspepsia: an updated meta-analysis of randomized, double-blind, placebo-controlled trials

Abstract

ObjectiveTo evaluate the efficacy and safety of traditional Chinese medicine (TCM) compounds for the treatment of functional dyspepsia (FD). MethodsThe PubMed, Embase, Cochrane Library, Web of Science, Chinese Biomedical Database (CBM), Wanfang Data, China National Knowledge Infrastructure (CNKI), and China Science and Technology Journal Database (VIP) were searched to collect randomized, double-blind, and placebo-controlled trials of FD treated with TCM compounds. The search duration was from the establishment of the database to March 2, 2021. After two researchers independently screened the literature, extracted the data, and evaluated the bias risk included in the study, they used RevMan 5.4 software for meta-analysis. ResultsA total of 23 clinical trials were included, including 2 898 patients. Meta-analysis showed that the overall remission rate of FD treated with TCM compounds was significantly higher than that of placebo (73.8% vs. 46.2%) [RR = 1.50, 95% CI (1.29, 1.76), P < 0.000 01]. Among the single symptoms, TCM compounds were superior to the placebo in improving epigastric pain [MD =-0.99, 95% CI (-1.37,-0.61), P < 0.000 01], epigastric burning sensation [MD =-0.32, 95% CI (-0.59,-0.05), P = 0.02], postprandial fullness discomfort [MD = -1.59, 95% CI (-1.96, -1.21), P < 0.000 01], and early satiety symptoms [MD = -0.93, 95% CI (-1.32, -0.54), P < 0.000 01]. Compared with the placebo, TCM compounds treatment can obviously improve TCM syndrome in patients with FD [MD = -5.58, 95% CI (-7.55,-3.61), P < 0.000 01], gastric emptying rate [MD = 12. 22, 95% CI (8.90, 15.55), P < 0.00001], and helped to improve patients' quality of life [MD = 11.27, 95% CI (0.10, 22.43), P = 0.05]. No severe adverse events were reported between the two groups [RR = 1.34, 95% CI (0.91, 1.96), P = 0.14]. ConclusionOur results showed that TCM compounds treatment could significantly alleviate FD symptoms, improve gastric emptying in FD patients, and help to improve their quality of life. No severe adverse reactions have been reported in clinical applications. Due to the limitation of the quantity and quality of the included studies, the above conclusions need to be verified by more high-quality studies.