Treatment Of Functional Dyspepsia Research Articles

Chemometric-based analysis and bioassay guided identification of potent compounds with intestinal motility promoting effects from Dalitong Granules

Ethnopharmacological relevanceDalitong Granules (DLT), a potent Traditional Chinese Medicine known for its ability to promote gastrointestinal motility, is widely used in clinical practice for the treatment of Functional Dyspepsia (FD). Despite the remarkable clinical efficacy of DLT, the specific components responsible for its effectiveness remains unclear. Aim of the studyThe study aimed to identify potential active ingredients of DLT for treating FD through spectrum-effect relationship analysis, multivariate statistical analysis and network pharmacology analysis. The efficacy of these identified compounds was subsequently validated using the zebrafish intestinal peristalsis model. Materials and methodsThe fingerprints of various solvent-extracted DLT were analyzed using high performance liquid chromatography coupled with tandem high-resolution mass spectrometry. The intestinal motility-promoting activities of DLT extracted by different solvents were evaluated through an intestinal propulsion test in mice. Potential therapeutic substances in DLT for treating FD were screened via chemometric analysis based on spectrum-effect relationship analysis. The correlation between the intensity of common peaks in the total ion chromatogram and the pharmacodynamic indices was assessed using multivariate statistical analysis. Additionally, given the complexity of Traditional Chinese Medicine, which comprises multiple components and targets, a network pharmacology analysis was performed to investigate the potential active ingredients in DLT. Finally, the pharmacological effects of these compounds in DLT were validated using a zebrafish intestinal motility model. ResultsThrough spectral-effect relationships analysis and network pharmacology analysis, it was determined that ten ingredients in DLT contribute to the promotion of intestinal motility. In a zebrafish intestinal motility model, it was observed that eight chemicals (excluding tetrahydropalmatine) demonstrate favorable activity of promoting gastrointestinal motility. These findings suggest that these ingredients may serve as potential therapeutic agents for improving gastric motility disorders. ConclusionsThis study employed spectral-effect relationship and network pharmacology analysis to identify the active ingredients in DLT. The findings were then validated using a zebrafish intestinal peristalsis model. These results provide a scientific foundation for the clinical application of DLT as a key traditional herbal formula for managing FD.

Efficacy of antidepressants in functional dyspepsia: Systematic review and meta-analysis with trial sequential analysis of randomized controlled trials.

The beneficial effects of using antidepressants in improving functional dyspepsia (FD) symptoms have been reported in previous meta-analyses; however, the results have not been conclusive. The aim was to perform an updated meta-analysis coupled with trial sequential analysis (TSA) to assess the efficacy of the use of any antidepressants in the treatment of FD in adults. Electronic databases were searched up to March 2024 for randomized controlled trials (RCTs) recruiting adults with FD. Data of overall symptoms improved between the antidepressants and placebo groups was pooled to obtain risk ratio (RR) employing the random-effects model. The effect of random errors was evaluated with TSA. The Grading of Recommendations Assessment, Development and Evaluation (GRADE)approach was used to assess the certainty of evidence. Analyses were performed using STATA version 16.0. Nine RCTs with 924 patients met the eligible criteria. The RRs of FD symptoms improving with any antidepressants, tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors were (n = 9, RR = 1.30 [95% CI, 1.02-1.67]), (n = 5, RR = 1.41 [95% CI, 1.07-1.85]) and (n = 2, RR = 0.97 [95% CI, 0.72-1.29]),respectively. TSA demonstrated conclusive evidence for the beneficial effect of TCAs. The number needed to treat (NNT) with any depressants and TCAs were 11 (95% CI, 7-36) and 6 (95% CI, 4-15), respectively. The certainty of the evidence for an effect of TCAs was that of moderate GRADE quality. The benefit, however, was limited to the western population (n = 3, RR = 1.43 [95% CI, 1.04-1.96]) and did not extend to the Asian population (n = 2, RR = 1.32 [95% CI, 0.75-2.32]). Conversely, antidepressant-using patients experienced adverse events more frequently. However, no statistically significant association was found between TCAs and any adverse events (n = 3; RR = 1.36 [95% CI, 0.91-2.04]). Evidence was obtained suggesting TCAs can be an effective alternative in the treatment of FD, but more evidence from high-quality large trials is required to support their use, especially in the Asian population.

The Treatment of Functional Dyspepsia Based on "Brain-gut Co-regulation" Theory

The Treatment of Functional Dyspepsia Based on "Brain-gut Co-regulation" Theory

A Case of Botulinum Toxin Injection for Treatment of Functional Dyspepsia

Functional dyspepsia is a condition with chronic indigestion symptoms such as epigastric pain or discomfort, early satiety, and bloating without an alternative organic disease. The symptoms are similar to those of functional dyspepsia, but abnormal retention of food in the stomach should be identified in gastroparesis. In this case, botulinum toxin injection was performed for treatment in a patient who complained of symptoms such as nausea, early satiety, abdominal distension, and poor appetite without no abnormal findings in gastric emptying scan. Through this case, a possibility was found that antral and pyloric dysfunction may cause symptoms of functional dyspepsia, without gastric emptying abnormalities.

Efficacy and safety of Xiangsha liujunzi decoction for functional dyspepsia: a systematic review and meta-analysis.

Functional dyspepsia is a highly prevalent digestive disorder. The limited effectiveness of current pharmaceutical interventions necessitates the exploration of alternative therapeutic options for functional dyspepsia. Xiangsha liujunzi decoction, a well-known traditional Chinese medicine formulation, has been widely employed in the treatment of functional dyspepsia in China. Nevertheless, the effectiveness of Xiangsha liujunzi decoction in the treatment of functional dyspepsia remains uncertain. To examine the effectiveness and safety of Xiangsha liujunzi decoction for treating functional dyspepsia. We retrieved seven databases containing randomized controlled trials on functional dyspepsia published up until 31 July 2023. The quality of these studies was evaluated using the Cochrane Risk of Bias assessment tool. The analysis of data was performed using the software RevMan 5.4. The total clinical effectiveness rate was evaluated as the primary outcome. In addition, gastric emptying rate, symptom score and safety evaluation were evaluated as the secondary outcomes. The meta-analysis included 23 studies, involving 2,101 individuals. Xiangsha liujunzi decoction demonstrated a significantly higher clinical effectiveness rate compared to the control group (RR 1.27; 95% CI 1.21, 1.33; p < 0.00001). Moreover, it exhibited superior gastric emptying rate and symptom score improvement compared to the control group. Nevertheless, no remarkable differences were detected in safety between Xiangsha liujunzi decoction and the control group (RR 0.67; 95% CI 0.16, 2.76; p = 0.58). The findings of this study suggest that Xiangsha liujunzi decoction exhibits effectiveness and no significant adverse events observed. However, because of the low quality of the enrolled studies, more high-quality and strict design randomized controlled trials are required in the future.

Silver nanoparticles stabilized by chitosan-polyvinyl alcohol polymers mediated by Pistacia extract for treatment of functional dyspepsia and gastric cancer

The impact of the nanoparticles on the dyspepsia mice gut microbiota is evaluated through the utilization of the 16S rRNA technique. Various methods were employed to characterize the NPs. In the textile, culinary, paper, leather, and printing sectors, synthetic dyes are frequently employed as coloring agents. Because these dye molecules are harmful to both the environment and living things, it is difficult to remove them sustainably. Here, we have produced nanoparticles embedded in chitosan-polyvinyl alcohol hydrogel (CS-PVA) by using bark's Pistacia under ultrasonic irradiation. The reduction of Ag + ions into Ag0 NPs was detected by a visual change in the colors. UV–Vis analysis indicated that the characteristic SPR band appeared near ∼440–450 nm. UV/Vis, EDX-elemental mapping, SEM, TEM, ICP-OES, and XRD analysis were applied to characterize the Ag NPs/CS-PVA nanocomposite. The recent study focused on the cellular and molecular aspects. The MTT assay was conducted for 48 h to evaluate the anti-human gastric cancer and cytotoxicity efficacies of the treated cells with nanocomposite. The assessment was performed on normal (HUVEC) and gastric cancer cells, namely MKN45 and NCI–N87. The IC50 values of nanocomposite against MKN45 and NCI–N87 were 180 and 151 μg/mL, respectively. The dose-dependent reduction in malignant gastric cell viability was observed in the nanocomposite presence. Furthermore, the nanocomposite induced cell apoptosis by 40–50%, leading to an increase in the expression of pro-apoptotic markers (Bax and cleaved caspase-8) and a decrease in the expression of the anti-apoptotic marker, Bcl-2. Furthermore, the nanocomposite showed inhibitory effects on colony formation. Our results indicate that the nanocomposite can increase p53 expression and decrease the expression of STAT3 in treated cells. This indicates that p53 and STAT3 play crucial roles in the biological effects induced by the extract in human gastric carcinoma cells. The data from the gut microbiome suggested that nanocomposites have the ability to control the rebalancing of homeostasis and microbiome composition by decreasing the levels of harmful bacteria, and at the same time, increasing the levels of beneficial bacteria. Following the introduction of nanocomposite, there was an observed rise in the levels of gastrointestinal hormones in the serum, including gastrin and motilin, while the levels of vasoactive intestinal peptide decreased. The application of nanocomposite led to an improvement in gastrointestinal movement, encompassing a rise in the rate of transit through the small intestine and the rate of gastric emptying. These findings offer that the Ag NPs/CS-PVA nanocomposite could be a promising anticancer treatment for functional dyspepsia and gastric cancer.

A Case Report of Functional Dyspepsia Treated with Beewha-eum

Objective: The purpose of this case study is to report the effectiveness of the Korean medicine Beewha-eum as a treatment for functional dyspepsia (FD).Methods: A patient diagnosed with a spleen-stomach deficiency-cold pattern in Korean medicine was treated with herbal medicines, including Beewha-eum. Symptom severity was assessed using the degree of self-reported dyspepsia (%), self-reported energy level, amount of food intake (%), total parenteral nutrition rate (cc/hour), body weight (kg), Nepean dyspepsia index (NDI-K), functional dyspepsia-related quality of life questionnaire (FD-QoL), and short form 36-item health survey (SF-36) score.Results: After treatment, the symptom severity of self-reported dyspepsia decreased from 100% to 10 to 15%, and the self-reported energy level increased from 20 to 80. The amount of food intake increased from 5% to 100%, and the total parenteral nutrition rate started from 60 cc/hour end in week 5. Body weight increased from 53.1 kg to 62 kg. The NDI-K score decreased from 105 to 31. The FD-QoL score increased from 19 to 68. The SF-36 score also increased from 102 to 116.Conclusion: The results suggest that the Korean medicine Beewha-eum could be an effective option for treating FD.

Efficacy and safety of Zhishixiaopi decoction in functional dyspepsia: A meta-analysis of randomized controlled trials.

Functional dyspepsia (FD) refers to a group of clinical symptoms caused by gastric and duodenal dysfunction. Which is a chronic functional disorder of the gastrointestinal tract with no cure. Zhishixiaopi decoction (ZSXP) is a type of Chinese herbal prescription that for treating FD. Although some randomized controlled trials (RCTs) report that ZSXP can significantly improve FD clinical symptoms and/or laboratory results, the trial design varies greatly among studies, making it challenging to draw a conclusion of the efficacy of ZSXP in treating FD. A systematic review and a meta-analysis. Mianyang Central Hospital. We conducted a systematic review and a meta-analysis to evaluate the efficacy and safety of ZSXP for treating FD. We developed inclusion and exclusion criteria based on FD diagnosed criteria, interventions to treat FD, and outcomes of these interventions. Search strategies combined disease terms, symptom terms, anatomy terms and intervention terms. Literature search was conducted on eight online databases in English or Chinese, including Medline (via PubMed), Embase (via Ovid), The Cochrane Library, Web of Science, China Biology Medicine (CBM), China National Knowledge Infrastructure (CNKI), Chinese Scientific Journals Database (VIP), and Wanfang Database. The experimental group received oral administration of ZSXP and had a complete treatment process. ZSXP needs to fully contain the key herbal ingredients, regardless of whether the dosage of each herb is consistent with the original prescription. The Control group received monotherapy or combination therapy of other Western medicine and had a complete treatment process. The primary outcomes appraised were Total effective rate (TER), serum levels of Motilin(MOT), Gastrin(GAS) and Somatostatin (SS), Gastric emptying rate (GER) using a Barium meal method (GER(B)) and Gastric half emptying time using an Ultrasonic method (GHET(T1/2)). The Cochrane Bias Risk Tool was used for quality critical appraisal, Review Manager (RevMan) version 5.3 was used for statistical analysis. A total of 21 medium-quality RCTs were included in the meta-analysis. All 21 included studies were conducted and completed in Mainland China from 1998 to 2020. The treatment duration was between two weeks to two months. The meta-analysis suggests that, compared with the Western medicine treatment group, ZSXP treatment was more effective to improving the TER in FD [Odds ratio, OR = 3.54, 95%CI:(2.49, 5.05), Z = 6.99, P<0.00001] without significant increase in adverse events. However, no statistical significance was found between the groups in serum MOT levels [Standard mean difference, SMD = 1.05, 95%CI:(-0.42, 2.53), Z = 1.04, P = 0.16], serum GAS levels [SMD = -0.16, 95%CI:(-1.20, 0.88), Z = 0.31, P = 0.76], serum SS levels [SMD = -0.04, 95%CI:(-1.97, 1.89), Z = 0.04, P = 0.97], GER(B) [SMD = 1.09, 95%CI:(-0.81, 3.00), Z = 1.12, P = 0.26]or GHET(T1/2) [Mean difference, MD = -2.18, 95%CI:(-5.55, 1.19), Z = 1.27, P = 0.20]. The meta-analysis suggests that Zhishixiaopi treatment is a relatively effective and safe traditional Chinese medicine prescription and could be used for functional dyspepsia treatment. Considering the limitations of this study, the conclusion needs to be further confirmed by high-quality, multi-center, and large-sample randomized controlled trials.

A bibliometric analysis of interstitial cells of Cajal research.

The significance of interstitial cells of Cajal (ICC) in the gastrointestinal tract has garnered increasing attention. In recent years, approximately 80 articles on ICC have been published annually in various journals. However, no bibliometric study has specifically focused on the literature related to ICC. Therefore, we conducted a comprehensive bibliometric analysis of ICC to reveal dynamic scientific developments, assisting researchers in exploring hotspots and emerging trends while gaining a global perspective. We conducted a literature search in the Web of Science Core Collection (WoSCC) from January 1, 2013, to December 31, 2023, to identify relevant literature on ICC. We employed bibliometric software, namely VOSviewer and CiteSpace, to analyze various aspects including annual publication output, collaborations, research hotspots, current status, and development trends in this domain. A total of 891 English papers were published in 359 journals by 928 institutions from 57 countries/regions. According to the keyword analysis of the literature, researchers mainly focused on "c-Kit," "expression," "smooth muscle," and "nitric oxide" related to ICC over the past 11 years. However, with "SIP syncytium," "ANO1," "enteric neurons," "gastrointestinal stromal tumors (GIST)," and "functional dyspepsia (FD)," there has been a growing interest in the relationship between ANO1, SIP syncytium, and ICC, as well as the role of ICC in the treatment of GIST and FD. Bibliometric analysis has revealed the current status of ICC research. The association between ANO1, SIP syncytium, enteric neurons and ICC, as well as the role of ICC in the treatment of GIST versus FD has become the focus of current research. However, further research and collaboration on a global scale are still needed. Our analysis is particularly valuable to researchers in gastroenterology, oncology, and cell biology, providing insights that can guide future research directions.

Comparison of the effects of Amomum tsaoko and its adulterants on functional dyspepsia rats based on metabolomics analysis

Amomum tsaoko (AT) is commonly used in clinical practice to treat abdominal distension and pain. It is also a seasoning for cooking, with the functions of appetizing, invigorating the spleen, and being digestive-promoting. Amomum tsaoko (AT) has three adulterants, Amomum paratsaoko (AP), Amomum koenigii (AK), and Alpinia katsumadai Hayata, because of the confusion in historical classics regarding recorded sources as well as the near geographic distribution and fruit morphological similarities. In this study, we established a functional dyspepsia (FD) rat model and then treated it with the corresponding medicinal solutions AT, AP, AK, and AKH. The gastric emptying rate, intestinal propulsion rate, serum biochemical indicators, histopathological changes, and fecal metabolism were measured. The efficacy and mechanism of AT, AP, AK, and AKH in the treatment of FD were compared. Fecal metabolomics revealed that 20 potential biomarkers were involved in seven significant metabolic pathways in FD rats. These pathways include ubiquinone and other terpenoid-quinone biosynthesis, glycerophospholipid metabolism, tyrosine metabolism, primary bile acid biosynthesis, purine metabolism, folate biosynthesis, and amino sugar and nucleotide sugar metabolism. AP regulates 6 metabolic pathways, 5 metabolic pathways affected by AT, 4 metabolic pathways affected by AK, and 2 metabolic pathways affected by AKH.The above results suggest that the different effects of AT, AP, AK, and AKH on FD rats may be due to their different regulatory effects on the metabolome.

Electroacupuncture improves low-grade duodenal inflammation in FD rats by reshaping intestinal flora through the NF-κB p65/NLRP3 pyroptosis pathway

Electroacupuncture (EA) is an effective alternative for the treatment of functional dyspepsia (FD). It reduces low-grade duodenal inflammation and improves the symptoms of FD by downregulating the expression of NF-κB p65 and NLRP3, but its mechanism needs to be elucidated. To examine the regulatory effect of electroacupuncture (EA) on intestinal flora and NF-κB p65/NLRP3 pyroptosis pathway in FD rats. The FD rat model was established via multi-factor stress intervention for two weeks. The rats were randomly divided into the NC group, model group, NF-kB inhibitor group (NF-κB inhibitor BAY 11–7082 was administered), EA group, and EA + NF-kB inhibitor group. After 14 days of treatment, the rats were sacrificed, and the protein and mRNA levels of NF-κB p65, IκB, and NLRP3 in the duodenum were evaluated by Western blotting assays and real-time fluorescent quantitative PCR. The Illumina MiSeq sequencing platform was used to analyze the V4 region of the 16S rRNA gene of intestinal flora and predict functional genes. The concentration of short-chain fatty acids (SCFAs) in feces was assessed by metabolomics. EA can decrease low-grade duodenal inflammation and promote gastrointestinal motility in FD rats. This effect is mediated by inhibition of the NF-κB p65/NLRP3 pyroptosis pathway, an increase in the alpha and beta diversity of gut microbiota in the duodenum, an increase in the abundance of beneficial bacteria at the phylum and genus levels, and an increase in the content of SCFAs. The protective effect of EA against FD might involve multiple hierarchy and pathways. EA may remodel intestinal flora by inhibiting the NF-κB p65/NLRP3 pyroptosis pathway, thereby improving low-grade duodenal inflammation in FD rats.

Qizhi Weitong Granules Alleviate Functional Dyspepsia-like Gastric Hypersensitivity in Rats by Inhibiting Inflammatory Cytokines and Strengthening Duodenal Mucosal Barrier

Background: Qizhi Weitong (QZWT) granules are a compound preparation of Chinese medicine, which are approved by theChina Food and Drug Administration for the treatment of functional dyspepsia (FD) and have been used in clinical practice fordecades. The objective of this study is to evaluate whether QZWT granules can alleviate gastric hypersensitivity by improvinglow-grade inflammation and the mucosal barrier in the duodenum in a functional dyspepsia-like (FD-like) model in rats.Methods: FD-like gastric hypersensitivity in adulthood was induced by iodoacetamide (IA) in neonatal rats. Thirty-twoSprague-Dawley (SD) rats were randomly classified into the control, model, QZWT, and Mosapride groups. Further, 0.2 mLof 0.1% iodoacetamide and 2.0% sucrose administrated by oral gavage was used to establish the FD-like rats model (oncea day, for six consecutive days). Electromyography (EMG) was used to evaluate the visceral motor response to gastricdilation. After treatment, the fluorescein isothiocyanate-glucan (FITC-glucan) test was performed to evaluate duodenalpermeability; enzyme-linked immunosorbent assay (ELISA) and quantitative polymerase chain reaction (qPCR) were used toevaluate the pro-inflammatory cytokines for duodenal epithelial cells and the tight junction (TJ) proteins of the duodenalmucosa. Results: The EMG score was elevated in the model group compared to the control group, but it decreased afterQZWT intervention; no changes were observed between the Mosapride and model groups. Compared with the controlgroup, rats in the gastric hypersensitivity model group showed a higher expression of interleukin-6 (IL-6) and tumor necrosisfactor-α (TNF-α) and lower expression of zona occludens protein 1 (ZO-1), occludin, and desmosome (DSG2) of junctionproteins (P &lt; 0.05); while in the QZWT group, the expression of IL-6 and TNF-α was reduced (P &lt; 0.01), and the expressionof ZO-1, occludin, and DSG2 was increased compared to the model group (P &lt; 0.05). Conclusion: QZWT granulesalleviate visceral hypersensitivity in an FD-like model in rats by inhibiting inflammatory cytokines IL-6 and TNF-α andregulating junction proteins.

Bioinformatics and LC-QTOF-MS based discovery of pharmacodynamic and Q-markers of Pitongshu against functional dyspepsia

Pitongshu (PTS) is a clinically effective empirical formula for the treatment of FD. The efficacy and safety of PTS have been demonstrated in randomized, controlled, double-blind trials, but there is a lack of understanding of the systematic evaluation of the efficacy of PTS and its material basis. To investigate the efficacy of PTS in Functional dyspepsia (FD) mice and possible Q-markers. In this study, we used "irregular feeding+chronic unpredictable chronic stimulation" to establish a mice model of FD with hepatogastric disharmony. The efficacy of PTS was assessed from hair condition, behavioral, pain, gastrointestinal function, and serum 5-HT, GAS, MTL levels in mice by instillation of different doses of PTS. In addition, the composition of drugs in blood was analyzed by LC-QTOF-MS and potential Q-markers were selected by combining network pharmacology, molecular docking and actual content. Our study showed that different doses of PTS increased pain threshold and writhing latency, decreased the number of writhings, increased gastric emptying rate and small intestinal propulsion rate, decreased total acidity of gastric contents and gastric acid secretion, and increased serum levels of 5-HT, GAS, and MTL in mice to different degrees. Enrichment analysis showed that PTS may be anti-FD through multiple pathways such as Serotonergic synapse, thyroid hormone signaling pathway, cholinergic synapse, and dopaminergic synapse. In addition, potential active ingredient substances were explored by LC-QTOF-MS combined with bioinformatics. Combined with the actual contentselected six constituents, hesperidin, neohesperidin, naringin, paeoniflorin, magnolol and honokiol, possible as Q-markers. PTS may exert its anti-FD effects through multi-component, multi-target and multi-pathway". Constituents, hesperidin, neohesperidin, naringin, paeoniflorin, magnolol and honokiol may be the Q-markers of its anti-FD effects.

Effects of Chinese ginger Alpinia officinarum-based phytopharmaceutical compound on gastric motility

BackgroundAlpinia officinarum, better known as Chinese ginger, is used for the treatment of gastrointestinal disorders in traditional Chinese and Ayurveda medicine. However, scientific evidence of an effect on gastrointestinal motility is missing. PurposeThis study aimed to estimate the effect of a phytopharmaceutical compound (PPC) based on Alpinia officinarum on gastric motility in vitro in order to assess its potential use in the treatment of functional dyspepsia. Study DesignWe investigated to which extent the compound affects the activity of gastric smooth muscle and we identified involved mediating cellular mechanisms. MethodsBasal and stimulated muscle activity were recorded from muscle-myenteric plexus preparations from three different regions of the guinea pig stomach before and after incubation with different concentrations of the PPC in an organ bath setup. Effect-mediating mechanisms were investigated by pharmacology. ResultsPPC exhibited a smooth muscle relaxation in a concentration-dependent manner. This was region- and muscle type specific as it was greater in fundus and corpus than in antrum and more pronounced in the circular than in the longitudinal muscle layer. The effect was primarily myogenic and at least partly mediated by TRPA1. ConclusionThe investigated PPC reduces basal tone particularly of fundus smooth muscle in a non-neuronal manner by inhibiting calcium influx via TRPA1, without affecting antral motility. Based on these data, Alpinia officinarum could be considered for phytopharmaceutical treatment of functional dyspepsia.

Modern Possibilities of Using Acotiamide in the Treatment of Functional Dyspepsia

Aim: to evaluate the efficacy and safety of the new prokinetic drug acotiamide in the treatment of functional dyspepsia.Key findings. Acotiamide is an antagonist of inhibitory muscarinic receptors of type 1 and 2 and a reversible inhibitor of acetylcholinesterase activity. In patients with functional dyspepsia acotiamide normalizes the accommodation of the fundal part of the stomach and accelerates delayed gastric emptying. The conducted studies have confirmed the higher efficacy of acotiamide compared to placebo in reducing the severity of such symptoms of functional dyspepsia as a feeling of epigastric postprandial fullness and bloating, early satiation. The advantage of acotiamide in comparison to other prokinetics (in particular, metoclopramide and domperidone) is the high safety of use and the absence of influence on the duration of the Q-T interval.Conclusion. The high efficacy and safety of the application makes it advisable to use acotiamide in the treatment of patients with functional dyspepsia.

Effect of Chaihu-Shugan-San on functional dyspepsia and gut microbiota: A randomized, double-blind, placebo-controlled trial

Ethnopharmacological relevanceChaihu-Shugan-San (CSS) is a classic traditional Chinese medicine (TCM) formula from the Ming Dynasty "Jingyue's Complete Works”. In China, it is prevalent for the treatment of a wide range of ailments, with a particular emphasis on functional gastrointestinal disorders (FGIDs). Clinical evidence suggests that CSS has been found to be a highly effective therapeutic approach for the treatment of Functional Dyspepsia (FD), however, there is a limited amount of high-quality clinical evidence, particularly randomized, double-blind, placebo-controlled trials to support this claim. Aim of the studyTo evaluate the therapeutic efficacy of Chaihu-Shugan-San (CSS) for treating functional dyspepsia (FD) by comparing it to placebos, as well as to investigate the impact of CSS on the gut microbiota in individuals diagnosed with FD. Materials and methodsThis was a randomized double-blind, placebo-controlled clinical trial implemented at Shuguang Hospital in Shanghai. Between May 2021 and December 2022, 94 participants satisfying the Rome IV diagnostic criteria for FD were enrolled. They were assigned randomly to either the CSS group or the placebo group, with an equal allocation ratio of 1:1. Patients in both groups received the intervention for four weeks. The primary outcome was the dyspepsia symptom scores evaluated by using single dyspepsia symptom scale (SDS) after four weeks of treatment. The secondary outcomes were the solid gastric empties rate measured by a barium strip method, Hamilton anxiety scale (HAMA), Hamilton depression scale (HAMD), and Functional dyspepsia Quality of life scale (FDDQL). In addition, after unblinding, 30 patients in the CSS group were randomly selected and divided into before and after treatment of the FD groups (FD1, FD2), and 30 healthy participants were selected as healthy control group (HC), and the gut microbiota was analyzed by 16S rRNA sequencing. ResultsAfter four weeks of treatment, the SDS score exhibited a significant improvement in the CSS group compared to the placebo group (t = 4.882; P ＜0.001). The difference in barium strip gastric emptying rate in the CSS group showed a significant ascent compared to the control group (P < 0.01). The HAMA, HAMD, and FDDQL scores in the CSS group showed a statistically significant increase compared to the control group (all P < 0.01). The results of 16S rRNA sequencing revealed that FD patients had less diverse and abundant microbiota than the healthy people. Additionally, the application of CSS resulted in the modulation of certain bacterial populations, leading to both up-regulation and down-regulation of their quantities. ConclusionsThese findings suggested that CSS is more effective compared to a placebo in treating FD, relieves anxiety and depression, increases gastric emptying rate in FD patients, and that CSS also affects the bacterial community structure in FD patients. Trial registrationChiCTR, ChiCTR2100045793. Registered 25 Mach 2021. URL: https://www.chictr.org.cn/showproj.html?proj=125049.

Chuna therapy include Space Spinal Conduction Exercise and Manipulation Treatment for Functional dyspepsia patients: A case report

Objectives: The purpose of this case study was to report the effect of Chuna therapy include Space Spinal Conduction Exercise and Manipulation Treatment for Functional dyspepsia patients.Methods: A 32-years-old male patients with functional dyspepsia visited the clinic ten times from March 17th 2023 to April 22th 2023. To assess the treatment outcomes, we used the Standard tool for pattern identification of Functional dyspepsia and Nepean Dyspepsia Index-Korean version (NDI-K) symptom score.Result: After treatment, Standard tool for pattern identification of Functional dyspepsia and Nepean Dyspepsia Index-Korean version (NDI-K) score decreased.Conclusion: Chuna therapy include Space Spinal Conduction Exercise and Manipulation Treatment was effective in the treatment of patient with Functional dyspepsia.

UPLC-Q-Exactive Orbitrap-MS and network pharmacology for deciphering the active compounds and mechanisms of stir-fried Raphani Semen in treating functional dyspepsia.

As a traditional digestive medicine, stir-fried Raphani Semen (SRS) has been used to treat food retention for thousands of years in China. Modern research has shown that SRS has a good therapeutic effect on functional dyspepsia (FD). However, the active components and mechanism of SRS in the treatment of FD are still unclear. The purpose of this study is to elucidate the material basis and mechanism of SRS for treating FD based on UPLC-Q-Exactive Orbitrap MS/MS combined with network pharmacology and molecular docking. The compounds of SRS water decoction were identified by UPLC-Q-Exactive Orbitrap MS/MS and the potential targets of these compounds were predicted by Swiss Target Prediction. FD-associated targets were collected from disease databases. The overlapped targets of SRS and FD were imported into STRING to construct Protein-Protein Interaction (PPI) network. Then, the Metascape was used to analyze Gene Ontology (GO) enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway after introducing overlapped targets. Finally, the active components and core targets were obtained by analyzing the "component-target-pathway" network, and the affinity between them was verified by molecular docking. 53 components were identified, and 405 targets and 1487 FD-related targets were collected. GO and KEGG analysis of 174 overlapped targets showed that SRS had important effects on hormone levels, serotonin synapses, calcium signaling pathway and cAMP signaling pathway. 7 active components and 15 core targets were screened after analyzing the composite network. Molecular docking results showed that multiple active components had high affinity with most core targets. SRS can treat FD through a variety of pathways, which provides a direction for the modern application of SRS in FD treatment.

Neuroimaging research progress of acupuncture treatment for patients with functional dyspepsia.

Neuroimaging technology provides objective and visualized research tool to study the mechanisms of acupuncture effects. Building on a systematic review of previous clinical studies on acupuncture treatment for functional dyspepsia using neuroimaging technology, this paper summarizes and synthesizes past researches from 4 aspects： acupoint-specific effects, factors influencing the effects, different physiological responses, and predictive factors for acupuncture efficacy. It suggests that acupuncture treatment for FD involves central integration with disease-targeted (acupuncture treatment can target and regulate abnormal brain functional activity patterns in patients with FD), meridian-specific (stimulation of specific acupuncture points along the stomach meridian can significantly regulate abnormal brain functional activity patterns in FD patients), and dynamic conditional features(the effects of acupuncture treatment for FD are influenced by multiple factors). Lastly, considering the current research status, this paper outlines prospects in terms of research subjects, influencing factors, and result validation, aiming to provide references for future in-depth research.

Insights and future prospects of traditional Chinese medicine in the treatment of functional dyspepsia

BackgroundFunctional dyspepsia (FD) is a prevalent and challenging gastrointestinal disorder. Conventional medicine often faces limitations in providing effective treatment for FD, thus indicating the need to explore alternative approaches. Traditional Chinese medicine (TCM), which is rooted in ancient Chinese traditions and has evolved over thousands of years, offers a holistic approach to well-being. TCM incorporates herbal remedies, acupuncture, and other therapies while shaping the future of complementary and alternative medicine. PurposeTo review the existing literature on the current status and future prospects of using TCM to treat FD. MethodsWe extensively searched the PubMed, Google Scholar, Embase, an China National Knowledge Internet databases from inception to May 31, 2023 to identify relevant literature. We also searched the reference lists of the included articles. ResultsClinical evidence-based research has explored the efficacy of TCM in treating FD. Recent research has illuminated the multifaceted mechanisms through which TCM interventions affect FD. TCM is a promising alternative, as it emphasizes a holistic approach and holds potential advantages in addressing the complex nature of FD. ConclusionsThe integration of TCM and Western medicine offers a comprehensive approach to understanding and managing FD by bridging traditional wisdom with modern scientific understanding. This paper highlights the practical implications of this integration, the challenges to be addressed, and the potential for international collaboration to further elucidate the efficacy of TCM. However, continued research and dialog are needed to advance the modern development of TCM and to improve the quality of life of FD patients.