Traditional Chinese patent medicine for bile reflux gastritis: a systematic review and network meta-analysis.

Abstract

Traditional Chinese Patent Medicine (TCPM) is widely used in the treatment of bile reflux gastritis (BRG). However, there is still a lack of research evaluating the efficacy of specific drugs. Thus, we conducted a reticulated meta-analysis to compare the efficacy of TCPMs in the treatment of BRG. We searched the China National Knowledge Infrastructure (CNKI), PubMed, Web of Science, and the Wanfang, and Embase databases, as of February 2021, for publications on the treatment of BRG with Chinese patent medicines in randomized controlled trials (RCTs). The main outcome indicator was the effective rate. The secondary outcome indicators were recurrence rate, traditional Chinese medicine (TCM) symptom score, and gastroscopic mucosal score. The Cochrane bias risk assessment tool was used to evaluate the research quality, and RevMan software (5.2) and Stata software (15.0) were used for the network meta-analysis. A total of 24 studies were included in the meta-analysis. In total, 2,417 patients were included in the meta-analysis, comprising 1,222 patients in the treatment group and 1,195 patients in the control group. The results of the network meta-analysis showed that Weiyankang capsules combined with hydrotalcite had the best effect in the treatment of bile reflux among the 14 interventions. Among the 5 studies that reported recurrence rates, patients administered Shugan Hewei pills had the lowest recurrence rate. A direct comparison showed that TCPMs or TCPMs combined with Western medicines had certain advantages in improving the scores of traditional Chinese medicine symptoms and mucosal scores under gastroscopy. Among all the Chinese patent medicines examined, Weiyankang capsules combined with hydrotalcite appeared to be the best choice for the treatment of BRG. However, due to limitations related to the quantity and quality of the research, more high-quality research needs to be conducted in the future to gather additional evidence. The protocol of this network meta-analysis was registered in PROSPERO with ID CRD42021247873.