Gastroesophageal reflux disease(GERD)has a high prevalence worldwide.Li et al performed a well-designed study on the efficacy of modified Xiaochaihu decoction(MXD)for GERD,which showed that MXD is an optional therapy ...Gastroesophageal reflux disease(GERD)has a high prevalence worldwide.Li et al performed a well-designed study on the efficacy of modified Xiaochaihu decoction(MXD)for GERD,which showed that MXD is an optional therapy for GERD beyond proton pump inhibitors(PPIs).The herbal granule administration mode minimized the bias from traditional herbal formula in clinical trials.One limitation of that study was that it lacked records of side effects and rescue medication.As a chronic disease with recurrent symptoms,GERD rehabilitation requires prolonged observation of the clinical course with MXD therapy.展开更多
Background:To systematically evaluate the efficacy and safety of traditional Chinese medicine in the treatment of refractory gastroesophageal reflux.Methods:PubMed,The Cochrane Library,Embase,Web of Science,China Nati...Background:To systematically evaluate the efficacy and safety of traditional Chinese medicine in the treatment of refractory gastroesophageal reflux.Methods:PubMed,The Cochrane Library,Embase,Web of Science,China National Knowledge Infrastructure,Wanfang Database,China Science and Technology Journal Database and Chinese BioMedical Literature Database were searched for randomized controlled trials of traditional Chinese medicine in the treatment of refractory gastroesophageal reflux from database establishment time to December 2020.After two researchers independently screened the literature,extracted data and evaluated the bias risk included in the study,RevMan5.3 software was used for meta-analysis.Results:A total of 12 randomized controlled trials,were included,including 893 patients.The results of meta-analysis showed that the total effective rate of the treatment group(relative risk=1.28,95%confidence interval(CI)(1.19,1.38),P<0.00001),RGERDQ(refractory gastroesophageal reflux disease)score(mean difference(MD)=−3.35,95%CI(−4.13,−2.57),P<0.00001],acid reflux(acid in the stomach comes out of the mouth)[MD=−0.30,95%CI(−0.45,−0.15),P<0.00001],heartburn(the feeling that the heart is burned)(MD=−0.44,95%CI(−0.60,−0.29),P<0.00001,and retrosternal pain(MD=−0.27,95%CI(−0.44,−0.10),P<0.00001,belching(MD=−0.40,95%CI(−0.57,−0.24),P<0.00001],endoscopic mucosal score(MD=−0.62,95%CI(−0.78,−0.46),P<0.00001],the differences were statistically significant,and the effective rate of mucosal improvement under endoscopy was P=0.93>0.05,with no statistically significant difference.Conclusion:The current evidence shows that traditional Chinese medicine in the treatment of refractory gastroesophageal reflux disease is better than that of western medicine in the total effective rate,relieving acid reflux,heartburn,retrosternal pain and belching symptoms,but it is impossible to judge the improvement of mucosa under endoscope.Due to the limitations of the quality and quantity of included studies,more high-quality studies are needed to confirm the above conclusions.展开更多
Background: Pyrosis and regurgitation are the cardinal symptoms of gastroesophageal reflux disease. Severalherbs have been used for treating gastrointestinal disorders worldwide. This systematic review was conducted t...Background: Pyrosis and regurgitation are the cardinal symptoms of gastroesophageal reflux disease. Severalherbs have been used for treating gastrointestinal disorders worldwide. This systematic review was conducted toinvestigate the effects of medicinal herbs on gastroesophageal reflux disease and adverse events. Methods:MEDLINE (via PubMed;The United States National Library of Medicine, USA), Scopus, ScienceDirect,Cochrane Central Register of Controlled Trials, Web of Science, Magiran, and Scientific Information Databasewere systematically searched for human studies, without a time frame, using medical subject heading terms such as“gastroesophageal reflux disease”, “reflux”, “esophagitis” and “herbs”. Manual searches completed the electronicsearches. Results: Thirteen randomized controlled trials were identified, including 1,164 participants from 1,509publications. In comparing herbal medicine to placebo, there were no significant differences in terms of heartburn(P = 0.23 and 0.48), epigastric or abdominal pain (P = 0.35), reflux syndrome (P = 0.12), and effective rate (P =0.60), but there was a significant difference in terms of acid regurgitation (P = 0.01). In comparing herbal medicineto drugs, there was a significant difference in terms of effective rate (P = 0.001), and there was one trial thatreported a significant difference in terms of epigastric pain (P = 0.00001). Also, in comparing herbal medicine todrugs, there were no significant differences in terms of acid regurgitation (P = 0.39). Conclusion: Thismeta-analysis showed that herbal medicines are effective in treating gastroesophageal reflux disease. Furtherstandardized researches with a large-scale, multicenter, and rigorous design are needed.展开更多
BACKGROUND Gastroesophageal reflux disease(GERD)has a high prevalence worldwide,and its incidence is increasing annually.Modified Xiaochaihu Decoction(MXD)could relieve the symptoms of GERD,but the effects of MXD on G...BACKGROUND Gastroesophageal reflux disease(GERD)has a high prevalence worldwide,and its incidence is increasing annually.Modified Xiaochaihu Decoction(MXD)could relieve the symptoms of GERD,but the effects of MXD on GERD manifestations and relapse prevention need to be further explained.Therefore,we performed a prospective,double-blind,and double-simulation study.AIM To verify the efficacy of MXD for GERD and its effect on esophageal motility.METHODS Using randomization,double-blinding,and a simulation design,288 participants with GERD were randomized to the treatment group and control group and received herbs(MXD)plus omeprazole simulation and omeprazole plus herbs simulation,respectively,for 4 wk.The GERD-Q scale score and esophageal manometry were measured at baseline,after treatment,and at 1 mo and 3 mo follow-up visits when medication was complete to evaluate recurrence indicators.RESULTS The GERD-Q scale score in both groups decreased significantly compared to those before treatment(P<0.01).However,no significant difference was observed between the two groups(P>0.05).Esophageal manometry showed that participants with lower esophageal sphincter pressure reduction and the proportion of ineffective swallowing(more than 50%)improved in both groups from baseline(P<0.01),especially in the treatment group(P<0.05).The percentage of small intermittent contractions,large intermittent contractions,and increased pre-phase contractions in the treatment group significantly improved compared with baseline(P<0.05)but did not improve in the control group(P>0.05).There was no significant difference between the groups after treatment(P>0.05).The percentage of weak esophageal contractility(distal contractile integral<450 mmHg·s·cm),improved in both groups(P<0.01),but no significant difference was observed between the groups after treatment(P>0.05).The relapse rate in the treatment group was lower than that in the control group at the 1 mo(P<0.01)and 3 mo follow-up(P<0.05).CONCLUSION MXD has a similar therapeutic effect to omeprazole in mild-to-moderate GERD.The therapeutic effect may be related to increased pressure in the lower esophageal sphincter and reduced ineffective swallowing.展开更多
Objective To identify specific Chinese medicines(CMs)that may benefit patients with gastroesophageal reflux disease(GERD),and explore the action mechanism.Methods Domestic and foreign literature on the treatment of GE...Objective To identify specific Chinese medicines(CMs)that may benefit patients with gastroesophageal reflux disease(GERD),and explore the action mechanism.Methods Domestic and foreign literature on the treatment of GERD with CMs was searched and selected from China National Knowledge Infrastructure,China Science and Technology Journal Database,Wanfang Database,and PubMed from October 1,2011 to October 1,2021.Data from all eligible articles were extracted to establish the database of CMs for GERD.Apriori algorithm of data mining techniques was used to analyze the rules of herbs selection and core Chinese medicine formulas were identified.A system pharmacology approach was used to explore the action mechanism of these medicines.Results A total of 278 prescriptions for GERD were analyzed,including 192 CMs.Results of Apriori algorithm indicated that Evodiae Fructus and Coptidis Rhizoma were the highest confidence combination.A total of 32 active ingredients and 66 targets were screened for the treatment of GERD.Enrichment analysis showed that the mechanisms of action mainly involved pathways in cancer,fluid shear stress and atherosclerosis,advanced glycation end product(AGE),the receptor for AGE signaling pathway in diabetic complications,bladder cancer,and rheumatoid arthritis.Conclusion Evodiae Fructus and Coptidis Rhizoma are the core drugs in the treatment of GERD and the potential mechanism of action of these medicines includes potential target and pathways.展开更多
Professor Xudong Tang believes that definite diagnosis is the key to gastroesophageal reflux disease treatment,and the treatment of refluxesophagitis should be combined with PH monitoring and clinical symptoms differe...Professor Xudong Tang believes that definite diagnosis is the key to gastroesophageal reflux disease treatment,and the treatment of refluxesophagitis should be combined with PH monitoring and clinical symptoms differentiation.Generally,according to the degree of acid regurgitation,it can be divided into different traditional Chinese medical syndromes:the liver-stomach depressionheat syndrome differentiation is the main type of acid regurgitation,while the liver-qi stagnation is the main type of acid regurgitation.In addition,attention should be paid to the step-down therapy of combination of traditional Chinese and Western medicine in the process of discontinuation.The lower efficacy of Western medicine should be used successively,together with traditional Chinese medicine Decoction,which can often achieve the effect of stopping recurrence.In addition,the traditional Chinese medicine prescription imitates Jianhua Dong's well-known old Chinese medicine thought,believing that the pathogenesis of gastroesophageal reflux disease is mainly Qi stagnation,the location of the disease is in the stomach,involving the liver and spleen.On the basis of Dr Dong Ganwei Baihe Decoction,the experience of treating gastroesophageal reflux disease with Lianzhu Liuyi Pill combined with Huagan Decoction was summarized.展开更多
Objective:To analyze Chinese medicine(CM)prescriptions for gastroesophageal reflux disease(GERD),we model topics on GERD-related classical CM literature,providing insights into the potential treatment.Methods:Clinical...Objective:To analyze Chinese medicine(CM)prescriptions for gastroesophageal reflux disease(GERD),we model topics on GERD-related classical CM literature,providing insights into the potential treatment.Methods:Clinical guidelines were used to identify symptom terms for GERD,and CM literature from the database"Imedbooks"was retrieved for related prescriptions and their corresponding sources,indications,and other information.BERTopic was applied to identify the main topics and visualize the data.Results:A total of 36,207entries are queried and 1,938 valid entries were acquired after manually filtering.Eight topics were identified by BERTopic,including digestion function abate,stomach flu,respiratory-related symptoms,gastric dysfunction,regurgitation and gastrointestinal dysfunction in pediatric patients,vomiting,stroke and alcohol accumulation are associated with the risk of GERD,vomiting and its causes,regurgitation,epigastric pain,and symptoms of heartburn.Conclusions:Topic modeling provides an unbiased analysis of classical CM literature on GERD in a time-efficient and scale-efficient manner.Based on this analysis,we present a range of treatment options for relieving symptoms,including herbal remedies and non-pharmacological interventions such as acupuncture and dietary therapy.展开更多
Background This study assessed the prevalence of gastroesophageal reflux disease(GERD)in a general adult population from Temuco in southern Chile.The association of GERD with demographic variables was also examined.Me...Background This study assessed the prevalence of gastroesophageal reflux disease(GERD)in a general adult population from Temuco in southern Chile.The association of GERD with demographic variables was also examined.Methods A cross-sectional study among the general population of Temuco in southern Chile was conducted in 2017,using a validated and reliable questionnaire for detecting GERD.The urban area of Temuco,with a population of 245,317 inhabitants(2002 census),was divided into four zones,which were representative of the socioeconomic sectors of the city.The sample size was estimated assuming a prevalence of 52.8%,an accuracy of 3.0%,a confidence level of 95.0%,and a design effect of 1.15.Area sampling was used to build clusters.The prevalence of GERD was determined and associated factors were studied by means of bivariate and multivariate analyses.Results A total of 1,069 subjects(47.9%women,median age 40 years)from the selected subareas were interviewed.The prevalence of GERD was 44.8%.The most frequently reported symptom was regurgitation(54.8%).One-third of subjects took medication to control symptoms and was considered‘sick’by the instrument,although>68%of them had never sought medical consultation.There was a significant association between GERD and age(P<0.001)and female gender(P=0.001).Conclusions In this population-based study,the prevalence of GERD was high(44.8%).GERD was associated with age and female gender.展开更多
基金Scientific Research Project of Zhejiang TCM Science and Technology Programme,No.2020ZB067,No.2020ZT001,and No.2021ZQ031National Natural Science Foundation of China,No.81503522 and No.82104862.
文摘Gastroesophageal reflux disease(GERD)has a high prevalence worldwide.Li et al performed a well-designed study on the efficacy of modified Xiaochaihu decoction(MXD)for GERD,which showed that MXD is an optional therapy for GERD beyond proton pump inhibitors(PPIs).The herbal granule administration mode minimized the bias from traditional herbal formula in clinical trials.One limitation of that study was that it lacked records of side effects and rescue medication.As a chronic disease with recurrent symptoms,GERD rehabilitation requires prolonged observation of the clinical course with MXD therapy.
文摘Background:To systematically evaluate the efficacy and safety of traditional Chinese medicine in the treatment of refractory gastroesophageal reflux.Methods:PubMed,The Cochrane Library,Embase,Web of Science,China National Knowledge Infrastructure,Wanfang Database,China Science and Technology Journal Database and Chinese BioMedical Literature Database were searched for randomized controlled trials of traditional Chinese medicine in the treatment of refractory gastroesophageal reflux from database establishment time to December 2020.After two researchers independently screened the literature,extracted data and evaluated the bias risk included in the study,RevMan5.3 software was used for meta-analysis.Results:A total of 12 randomized controlled trials,were included,including 893 patients.The results of meta-analysis showed that the total effective rate of the treatment group(relative risk=1.28,95%confidence interval(CI)(1.19,1.38),P<0.00001),RGERDQ(refractory gastroesophageal reflux disease)score(mean difference(MD)=−3.35,95%CI(−4.13,−2.57),P<0.00001],acid reflux(acid in the stomach comes out of the mouth)[MD=−0.30,95%CI(−0.45,−0.15),P<0.00001],heartburn(the feeling that the heart is burned)(MD=−0.44,95%CI(−0.60,−0.29),P<0.00001,and retrosternal pain(MD=−0.27,95%CI(−0.44,−0.10),P<0.00001,belching(MD=−0.40,95%CI(−0.57,−0.24),P<0.00001],endoscopic mucosal score(MD=−0.62,95%CI(−0.78,−0.46),P<0.00001],the differences were statistically significant,and the effective rate of mucosal improvement under endoscopy was P=0.93>0.05,with no statistically significant difference.Conclusion:The current evidence shows that traditional Chinese medicine in the treatment of refractory gastroesophageal reflux disease is better than that of western medicine in the total effective rate,relieving acid reflux,heartburn,retrosternal pain and belching symptoms,but it is impossible to judge the improvement of mucosa under endoscope.Due to the limitations of the quality and quantity of included studies,more high-quality studies are needed to confirm the above conclusions.
文摘Background: Pyrosis and regurgitation are the cardinal symptoms of gastroesophageal reflux disease. Severalherbs have been used for treating gastrointestinal disorders worldwide. This systematic review was conducted toinvestigate the effects of medicinal herbs on gastroesophageal reflux disease and adverse events. Methods:MEDLINE (via PubMed;The United States National Library of Medicine, USA), Scopus, ScienceDirect,Cochrane Central Register of Controlled Trials, Web of Science, Magiran, and Scientific Information Databasewere systematically searched for human studies, without a time frame, using medical subject heading terms such as“gastroesophageal reflux disease”, “reflux”, “esophagitis” and “herbs”. Manual searches completed the electronicsearches. Results: Thirteen randomized controlled trials were identified, including 1,164 participants from 1,509publications. In comparing herbal medicine to placebo, there were no significant differences in terms of heartburn(P = 0.23 and 0.48), epigastric or abdominal pain (P = 0.35), reflux syndrome (P = 0.12), and effective rate (P =0.60), but there was a significant difference in terms of acid regurgitation (P = 0.01). In comparing herbal medicineto drugs, there was a significant difference in terms of effective rate (P = 0.001), and there was one trial thatreported a significant difference in terms of epigastric pain (P = 0.00001). Also, in comparing herbal medicine todrugs, there were no significant differences in terms of acid regurgitation (P = 0.39). Conclusion: Thismeta-analysis showed that herbal medicines are effective in treating gastroesophageal reflux disease. Furtherstandardized researches with a large-scale, multicenter, and rigorous design are needed.
基金Supported by Capital Characteristic Study of Clinical Application,Beijing Municipal Science&Technology Commission,No.Z141107002514176Capital Health Development Research Project,No.2018-2-2231.
文摘BACKGROUND Gastroesophageal reflux disease(GERD)has a high prevalence worldwide,and its incidence is increasing annually.Modified Xiaochaihu Decoction(MXD)could relieve the symptoms of GERD,but the effects of MXD on GERD manifestations and relapse prevention need to be further explained.Therefore,we performed a prospective,double-blind,and double-simulation study.AIM To verify the efficacy of MXD for GERD and its effect on esophageal motility.METHODS Using randomization,double-blinding,and a simulation design,288 participants with GERD were randomized to the treatment group and control group and received herbs(MXD)plus omeprazole simulation and omeprazole plus herbs simulation,respectively,for 4 wk.The GERD-Q scale score and esophageal manometry were measured at baseline,after treatment,and at 1 mo and 3 mo follow-up visits when medication was complete to evaluate recurrence indicators.RESULTS The GERD-Q scale score in both groups decreased significantly compared to those before treatment(P<0.01).However,no significant difference was observed between the two groups(P>0.05).Esophageal manometry showed that participants with lower esophageal sphincter pressure reduction and the proportion of ineffective swallowing(more than 50%)improved in both groups from baseline(P<0.01),especially in the treatment group(P<0.05).The percentage of small intermittent contractions,large intermittent contractions,and increased pre-phase contractions in the treatment group significantly improved compared with baseline(P<0.05)but did not improve in the control group(P>0.05).There was no significant difference between the groups after treatment(P>0.05).The percentage of weak esophageal contractility(distal contractile integral<450 mmHg·s·cm),improved in both groups(P<0.01),but no significant difference was observed between the groups after treatment(P>0.05).The relapse rate in the treatment group was lower than that in the control group at the 1 mo(P<0.01)and 3 mo follow-up(P<0.05).CONCLUSION MXD has a similar therapeutic effect to omeprazole in mild-to-moderate GERD.The therapeutic effect may be related to increased pressure in the lower esophageal sphincter and reduced ineffective swallowing.
基金Supported by the Natural Science Foundation of Hebei(No.H2020423207)the Postgraduate Innovation Funding Project of Hebei University of Chinese Medicine(No.XCXZZSS2022023)。
文摘Objective To identify specific Chinese medicines(CMs)that may benefit patients with gastroesophageal reflux disease(GERD),and explore the action mechanism.Methods Domestic and foreign literature on the treatment of GERD with CMs was searched and selected from China National Knowledge Infrastructure,China Science and Technology Journal Database,Wanfang Database,and PubMed from October 1,2011 to October 1,2021.Data from all eligible articles were extracted to establish the database of CMs for GERD.Apriori algorithm of data mining techniques was used to analyze the rules of herbs selection and core Chinese medicine formulas were identified.A system pharmacology approach was used to explore the action mechanism of these medicines.Results A total of 278 prescriptions for GERD were analyzed,including 192 CMs.Results of Apriori algorithm indicated that Evodiae Fructus and Coptidis Rhizoma were the highest confidence combination.A total of 32 active ingredients and 66 targets were screened for the treatment of GERD.Enrichment analysis showed that the mechanisms of action mainly involved pathways in cancer,fluid shear stress and atherosclerosis,advanced glycation end product(AGE),the receptor for AGE signaling pathway in diabetic complications,bladder cancer,and rheumatoid arthritis.Conclusion Evodiae Fructus and Coptidis Rhizoma are the core drugs in the treatment of GERD and the potential mechanism of action of these medicines includes potential target and pathways.
基金Beijing Science and Technology New Star Project(Z1511000003150125)Beijing Science and Technology Research Institute(PXM2017-026273-000003)+1 种基金Beijing Double Hundred ProjectNational Natural Science Foundation of China(81774146).
文摘Professor Xudong Tang believes that definite diagnosis is the key to gastroesophageal reflux disease treatment,and the treatment of refluxesophagitis should be combined with PH monitoring and clinical symptoms differentiation.Generally,according to the degree of acid regurgitation,it can be divided into different traditional Chinese medical syndromes:the liver-stomach depressionheat syndrome differentiation is the main type of acid regurgitation,while the liver-qi stagnation is the main type of acid regurgitation.In addition,attention should be paid to the step-down therapy of combination of traditional Chinese and Western medicine in the process of discontinuation.The lower efficacy of Western medicine should be used successively,together with traditional Chinese medicine Decoction,which can often achieve the effect of stopping recurrence.In addition,the traditional Chinese medicine prescription imitates Jianhua Dong's well-known old Chinese medicine thought,believing that the pathogenesis of gastroesophageal reflux disease is mainly Qi stagnation,the location of the disease is in the stomach,involving the liver and spleen.On the basis of Dr Dong Ganwei Baihe Decoction,the experience of treating gastroesophageal reflux disease with Lianzhu Liuyi Pill combined with Huagan Decoction was summarized.
基金Supported by Shanghai Municipal Administrator of Traditional Chinese Medicine[No.ZY(2021-2023)-0301-01]the National Nature Science Foundation of China(No.82074366)。
文摘Objective:To analyze Chinese medicine(CM)prescriptions for gastroesophageal reflux disease(GERD),we model topics on GERD-related classical CM literature,providing insights into the potential treatment.Methods:Clinical guidelines were used to identify symptom terms for GERD,and CM literature from the database"Imedbooks"was retrieved for related prescriptions and their corresponding sources,indications,and other information.BERTopic was applied to identify the main topics and visualize the data.Results:A total of 36,207entries are queried and 1,938 valid entries were acquired after manually filtering.Eight topics were identified by BERTopic,including digestion function abate,stomach flu,respiratory-related symptoms,gastric dysfunction,regurgitation and gastrointestinal dysfunction in pediatric patients,vomiting,stroke and alcohol accumulation are associated with the risk of GERD,vomiting and its causes,regurgitation,epigastric pain,and symptoms of heartburn.Conclusions:Topic modeling provides an unbiased analysis of classical CM literature on GERD in a time-efficient and scale-efficient manner.Based on this analysis,we present a range of treatment options for relieving symptoms,including herbal remedies and non-pharmacological interventions such as acupuncture and dietary therapy.
基金supported by Project MEC 80170022,CONICYT Chile 2018.The funding body collaborated in the design of the study and interpretation of data and in writing the manuscript.
文摘Background This study assessed the prevalence of gastroesophageal reflux disease(GERD)in a general adult population from Temuco in southern Chile.The association of GERD with demographic variables was also examined.Methods A cross-sectional study among the general population of Temuco in southern Chile was conducted in 2017,using a validated and reliable questionnaire for detecting GERD.The urban area of Temuco,with a population of 245,317 inhabitants(2002 census),was divided into four zones,which were representative of the socioeconomic sectors of the city.The sample size was estimated assuming a prevalence of 52.8%,an accuracy of 3.0%,a confidence level of 95.0%,and a design effect of 1.15.Area sampling was used to build clusters.The prevalence of GERD was determined and associated factors were studied by means of bivariate and multivariate analyses.Results A total of 1,069 subjects(47.9%women,median age 40 years)from the selected subareas were interviewed.The prevalence of GERD was 44.8%.The most frequently reported symptom was regurgitation(54.8%).One-third of subjects took medication to control symptoms and was considered‘sick’by the instrument,although>68%of them had never sought medical consultation.There was a significant association between GERD and age(P<0.001)and female gender(P=0.001).Conclusions In this population-based study,the prevalence of GERD was high(44.8%).GERD was associated with age and female gender.
