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. 2020 Jul 16:11:884.
doi: 10.3389/fphar.2020.00884. eCollection 2020.

Different Traditional Herbal Medicines for the Treatment of Gastroesophageal Reflux Disease in Adults

Yun-Kai Dai  1   2 , Yun-Bo Wu  1   2 , Hao Wen  3 , Ru-Liu Li  1   2 , Wei-Jing Chen  1   2 , Chunzhi Tang  3 , Liming Lu  3 , Ling Hu  1   2
Affiliations

Different Traditional Herbal Medicines for the Treatment of Gastroesophageal Reflux Disease in Adults

Yun-Kai Dai et al. Front Pharmacol. .

Abstract

Background/aims: Traditional Herbal Medicines (THM) have been being used for gastroesophageal reflux disease (GERD) for a long time, but clinical evidence is still scarce. We evaluated different THM prescriptions for GERD in adults.

Methods: Data added to nine online databases from their inception to November 30, 2019, were systematically searched. All relevant randomized controlled trials (RCTs) were included and were combined with Bayesian network analysis. The Cochrane Collaboration's risk of bias tool and GRADE profiler version 3.6 were respectively employed to evaluate the quality of evidence of outcomes.

Results: Seventeen publications involving 1441 participants were retrieved. The results of our analysis suggested that Jianpi therapy+proton pump inhibitors (PPIs) and Ligan Hewei therapy respectively ranked first in overall clinical efficacy and efficacy under gastroscope; Ligan Hewei therapy+PPIs was the optimum intervention in the improvement of acid regurgitation and heartburn.

Conclusion: This research indicates that Ligan Hewei therapy and Jianpi therapy, or these therapies separately combined with PPIs, should be recommended as appropriate complementary and alternative treatments based on the specific characteristics of GERD. However, additional well-designed RCTs with high methodological quality are still needed for future research.

Keywords: adults; gastroesophageal reflux disease; network analysis; randomized controlled trials; traditional herbal medicines.

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Figures

Figure 1
Figure 1
Flow diagram.
Figure 2
Figure 2
Usage frequency of the included herbs.
Figure 3
Figure 3
Risk of bias. (A) Summary. (B) Graph.
Figure 4
Figure 4
Network evidence diagrams of four endpoints. (A) Overall clinical efficacy. (B) Improvement of acid regurgitation. (C) Efficacy under gastroscope. (D) Improvement of heartburn.
Figure 5
Figure 5
The surface under the cumulative ranking curve (SUCRA) plots of four endpoints. (A) Overall clinical efficacy. (B) Efficacy under gastroscope.(C) Improvement of acid regurgitation. (D) Improvement of heartburn.
Figure 6
Figure 6
Sensitivity analyses of (A) overall clinical efficacy and (B) efficacy under gastroscope.
Figure 7
Figure 7
GRADE quality grading evaluation.
See this image and copyright information in PMC

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