Objective To evaluate the efficacy and safety of traditional Chinese medicine(TCM)compounds for the treatment of functional dyspepsia(FD).Methods The Pub Med,Embase,Cochrane Library,Web of Science,Chinese Biomedical D...Objective To evaluate the efficacy and safety of traditional Chinese medicine(TCM)compounds for the treatment of functional dyspepsia(FD).Methods The Pub Med,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 Rev Man 5.4 software for meta-analysis.Results A total of 23 clinical trials were included,including 2898 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<0.00001].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<0.00001],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<0.00001],and early satiety symptoms[MD=﹣0.93,95%CI(﹣1.32,﹣0.54),P<0.00001].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<0.00001],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].Conclusion Our 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.展开更多
Objective:To review systematically the therapeutic effect and safety of acupuncture or electroacupuncture(EA)on functional dyspepsia(FD).Methods:Using computer,the randomized controlled trials(RCTs)of FD treated with ...Objective:To review systematically the therapeutic effect and safety of acupuncture or electroacupuncture(EA)on functional dyspepsia(FD).Methods:Using computer,the randomized controlled trials(RCTs)of FD treated with acupuncture or EA were retrieved from the databases,i.e.Cochrane Library,PubMed,EMbase and Web of science,from the date of database establishment to June 1,2020.Using the assessment tool of risk of bias in Cochrane Handbook for systematic reviews of interventions,5.1.0,the quality of the included RCTs were evaluated in methodology.Meta-analysis was performed by RevMan 5.3 software.Results:A total of 10 articles were included,with 1202 cases involved.In this study,the effectiveness of EA or acupuncture on FD was analyzed in comparison with the treatment with sham-acupuncture,sham-EA or western medication.The results indicated that compared with sham-acupuncture or shamEA,acupuncture or EA greatly relieved the clinical symptoms of FD(SMD=-3.03,95%Cl[-3.56,-2.50],P<0.00001)and obtained a higher clinical response rate(OR=5.09,95%CI[3.30,7.86],P<0.00001),but the difference was not significant statistically in gastric electrical activity(P>0.05).Compared with gastric prokinetics,acupuncture or EA more effectively reduced the symptom score(MD=-3.03,95%CI[-3.56,-2.50],P=0.02),but the differences were not significant in the aspects of the improvement of clinical effective rate(OR=1.33,95%CI[0.70,2.52],P=0.39),the promotion of gastric half-emptying(MD=0.23,95%Cl[-1.94,2.40],12=0%,P=0.83),the promotion of motilin secretion(SMD=-0.06,95%CI[-0.23,0.11],I^(2)=0%,P=0.50)and the increase of gastric electrical activity(MD=-0.01,95%Cl[-0.03,0.01],I^(2)=0%,P=0.41).The three RCT studies with adverse events reported indicated that the difference in the incidence of the adverse events was not significant statistically in comparison of acupuncture with sham-acupuncture or gastric prokinetic agent(P<0.05).Conclusion:Regarding the improvement in the symptoms of FD,the effect of EA or acupuncture is superior to the sham-acupuncture group or the western medication group.Simultaneously,the clinical response rate in the treatment with EA or acupuncture is higher than the sham-acupuncture group.During the treatment with EA,some adverse reactions happened in treatment of FD with acupuncture or western medication.Even though there are the limitations in quality and quantity of the included trials,EA and acupuncture still deserve to be promoted in treatment of FD.However,more studies of RCTs with largescale sample,high quality and multiple centers are required for a further verification of the therapeutic effect.展开更多
基金funding support from the National Natural Science Foundation of China Project(No.81820108033)the Project of Wangjing Hospital,China Academy of Chinese Medical Sciences(No.WJYY2020-18)。
文摘Objective To evaluate the efficacy and safety of traditional Chinese medicine(TCM)compounds for the treatment of functional dyspepsia(FD).Methods The Pub Med,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 Rev Man 5.4 software for meta-analysis.Results A total of 23 clinical trials were included,including 2898 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<0.00001].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<0.00001],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<0.00001],and early satiety symptoms[MD=﹣0.93,95%CI(﹣1.32,﹣0.54),P<0.00001].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<0.00001],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].Conclusion Our 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.
文摘Objective:To review systematically the therapeutic effect and safety of acupuncture or electroacupuncture(EA)on functional dyspepsia(FD).Methods:Using computer,the randomized controlled trials(RCTs)of FD treated with acupuncture or EA were retrieved from the databases,i.e.Cochrane Library,PubMed,EMbase and Web of science,from the date of database establishment to June 1,2020.Using the assessment tool of risk of bias in Cochrane Handbook for systematic reviews of interventions,5.1.0,the quality of the included RCTs were evaluated in methodology.Meta-analysis was performed by RevMan 5.3 software.Results:A total of 10 articles were included,with 1202 cases involved.In this study,the effectiveness of EA or acupuncture on FD was analyzed in comparison with the treatment with sham-acupuncture,sham-EA or western medication.The results indicated that compared with sham-acupuncture or shamEA,acupuncture or EA greatly relieved the clinical symptoms of FD(SMD=-3.03,95%Cl[-3.56,-2.50],P<0.00001)and obtained a higher clinical response rate(OR=5.09,95%CI[3.30,7.86],P<0.00001),but the difference was not significant statistically in gastric electrical activity(P>0.05).Compared with gastric prokinetics,acupuncture or EA more effectively reduced the symptom score(MD=-3.03,95%CI[-3.56,-2.50],P=0.02),but the differences were not significant in the aspects of the improvement of clinical effective rate(OR=1.33,95%CI[0.70,2.52],P=0.39),the promotion of gastric half-emptying(MD=0.23,95%Cl[-1.94,2.40],12=0%,P=0.83),the promotion of motilin secretion(SMD=-0.06,95%CI[-0.23,0.11],I^(2)=0%,P=0.50)and the increase of gastric electrical activity(MD=-0.01,95%Cl[-0.03,0.01],I^(2)=0%,P=0.41).The three RCT studies with adverse events reported indicated that the difference in the incidence of the adverse events was not significant statistically in comparison of acupuncture with sham-acupuncture or gastric prokinetic agent(P<0.05).Conclusion:Regarding the improvement in the symptoms of FD,the effect of EA or acupuncture is superior to the sham-acupuncture group or the western medication group.Simultaneously,the clinical response rate in the treatment with EA or acupuncture is higher than the sham-acupuncture group.During the treatment with EA,some adverse reactions happened in treatment of FD with acupuncture or western medication.Even though there are the limitations in quality and quantity of the included trials,EA and acupuncture still deserve to be promoted in treatment of FD.However,more studies of RCTs with largescale sample,high quality and multiple centers are required for a further verification of the therapeutic effect.