Abstract
A peptic ulcer (PU) is a digestive disorder most commonly found in clinical practice. An oriental herbal formula, Xiao Chai Hu Tang (XCHT), has been used to treat PU for an extended period in China. The effectiveness and safety of XCHT in treating peptic ulcers was evaluated using a systematic review of randomized controlled trials (RCTs). Studies were systematically retrieved from CNKI, Embase, Medline, PubMed, SinoMed, VIP, Wanfang, and Web of Science. The following information was extracted from the relevant RCTs: the clinical efficacy rate, recurrence rate, clinical efficacy of traditional Chinese medicine, and the adverse effects. 13 RCTs, including 1334 patients, were included in this review. The meta-analysis showed that treatment with XCHT was superior to conventional pharmacotherapy (CPT) in improving the clinical efficacy rate (RR: 1.20, 95% confidence intervals (CIs): 1.08–1.34, P=0.0007), poor appetite (RR: 0.30, 95% CI: 0.15–0.61, P=0.0009), abdominal distension (RR: 0.61, 95% CI: 0.39–0.96, P=0.03), vomiting (RR: 0.33, 95% CI: 0.19–0.55, P < 0.0001), and stomach pain (RR: 0.36, 95% CI: 0.19–0.68, P=0.002) and reducing adverse events (RR: 0.23, 95% CI: 0.07–0.69, P=0.009). XCHT considerably increased the total clinical efficacy rate (RR: 1.22, 95% CI: 1.15–1.30, P < 0.00001) as both monotherapy and adjunctive therapy. The recurrence rate (RR = 0.29; 95% CI: 0.16–0.52, P < 0.0001) was remarkably decreased in the XCHT plus CPT group. The meta-analysis did not show a significant beneficial effect of XCHT compared with CPT in reducing the recurrence rate (RR = 0.45; 95% CI: 0.07–3.10, P=0.42) and acid reflux (RR: 0.76, 95% CI: 0.47–1.23, P=0.26). Our findings show that XCHT can treat peptic ulcers as part of an alternative medicine approach.
Highlights
peptic ulcer (PU) is defined as ulceration inside the gastrointestinal (GI) mucosa, which occurs due to erosion induced by peptic acid
Our findings show that XCHTcan treat peptic ulcers as part of an alternative medicine approach
A total of 1334 patients aged 30–59 years were included, of whom 669 and 665 were in the intervention and control groups, respectively. ere were 13 studies with two arms published from 2009 to 2017. e sample sizes ranged from 30 to 100, with a trial duration ranging from 28 to 75 days. e participants of the Records identified through database searching (n = 653)
Summary
PU is defined as ulceration inside the gastrointestinal (GI) mucosa, which occurs due to erosion induced by peptic acid. Gastric ulcer (GU) and duodenal ulcer (DU) [1] mostly happen in the stomach or proximal duodenum but can occur in the esophagus as well as Meckel’s diverticulum [2]. PU’s primary treatment has been triple or quadruple therapy, a western medicine (WM) approach. Patients treated by WM have a comparatively high recurrence rate after surgery and ongoing treatment effects. Patients can be affected by several adverse reactions during WM treatment [4, 5]. Strategies focused on traditional Chinese medicine (TCM) have attracted increasing interest
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