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Research on the effects of Chinese medicine in the treatment of upper digestive disorders

Last updated: 11 March, 2017
by Steven Clavey, Traditional Chinese Gynaecology

Acupuncture for the treatment of gastro-oesophageal reflux disease: a systematic review and meta-analysis

Acupuncture is an effective and safe treatment for gastro-oesophageal reflux disease (GORD/GERD) according a systematic review by authors from the USA and China. A total of 12 trials involving 1235 patients were included in their meta-analyses, which demonstrated that patients receiving (manual or electro-) acupuncture combined with Western medicine (WM) demonstrated superior global symptom improvement compared with those receiving WM alone. In addition, recurrence rates for those receiving acupuncture alone were found to be lower than those receiving WM alone, while global symptom improvement and symptom scores were similar for both therapies. Acupuncture was also observed to improve quality of life in patients with GORD.

Acupuncture for the treatment of gastro-oesophageal reflux disease: a systematic review and meta-analysis. Acupunct Med 2017;0:1–6.

 

Efficacy and safety of Xiangsha Liujunzi granules for functional dyspepsia: A multi-center randomized double-blind placebo-controlled clinical study.

This study of 216 subjects in a randomized, double-blind, placebo-controlled trial found that a traditional formula commonly used for digestive problems provided significant symptomatic improvement in patients with functional dyspepsia.

Note: 75% of patients with unintentional weight loss, recurrent vomiting and difficulty swallowing have ‘functional dyspepsia’ (ie, no structural abnormality such as an ulcer). All they have is symptoms. This formula helped.

World J Gastroenterol. 2017 Aug 14;23(30):5589-5601. Lv L, Wang FY, Ma XX, Li ZH, Huang SP, Shi ZH, Ji HJ, Bian LQ, Zhang BH, Chen T, Yin XL, Tang XD.

AIM: To assess the efficacy and safety of a Chinese herbal medicine (CHM), Xiangsha Liujunzi granules, in the treatment of patients with functional dyspepsia (FD).

METHODS: We performed a randomized, double-blind, placebo-controlled trial with patients from three centers. Two hundred and sixteen subjects diagnosed with FD according to ROME III criteria and confirmed by upper gastrointestinal endoscopy and spleen-deficiency and Qi-stagnation syndrome were selected to receive Xiangsha Liujunzi granules or placebo for 4 wk in a 2:1 ratio by blocked randomization. The subjects also received follow-up after the 4-wk intervention. Herbal or placebo granules were dissolved in 300 mL of water. Participants in both groups were administered 130 mL (45 °C) three times a day. Participants were evaluated prior to and following 4 wk of the intervention in terms of changes in the postprandial discomfort severity scale (PDSS) score, clinical global impression (CGI) scale score, hospital anxiety and depression scale (HADS) score, traditional Chinese medicine symptoms score (SS), scores of various domains of the 36-item short form health survey (SF-36), gastric emptying (GE) and any observed adverse effects.

RESULTS: Compared with the placebo group, patients in the CHM group showed significant improvements in the scores of PDSS, HADS, SS, SF-36 and CGI scale (P < 0.05 or P < 0.01). They also showed the amelioration in the GE rates of the proximal stomach and distal stomach (P < 0.05 or P < 0.01).

CONCLUSION: Xiangsha Liujunzi granules offered significant symptomatic improvement in patients with FD.

 

Xiaoyao pill for treatment of functional dyspepsia in perimenopausal women with depression.

In this study of another traditional formulation, the authors of this double-blind, randomized, controlled trial of 180 patients with functional dyspepsia found that “the Xiaoyao pill is effective and safe for the treatment of perimenopausal women with FD associated with depression.

World J Gastroenterol. 2014 Nov 28;20(44):16739-44. doi: 10.3748/wjg.v20.i44.16739.

Du HG, Ming L, Chen SJ, Li CD.

AIM: To evaluate the efficacy and safety of the Xiaoyao pill for treatment of functional dyspepsia (FD) associated with perimenopausal depression.

METHODS: This was a double-blind, randomized, controlled trial including 180 patients with FD accompanied by depression that were divided into two groups of 90. Patients in the treatment group received oral administration of the Xiaoyao pill for soothing the liver and activating the spleen, and patients in the control group received a placebo. This trial included an 8-wk therapy period with a follow-up period of 6 mo. The total efficacy and degree of depression, as assessed by the Hamilton Rating Scale for Depression (HRSD), were evaluated. Plasma levels of motilin and gastrin were measured and a gastric emptying test was conducted in each participant.

RESULTS: The Xiaoyao pill had a good therapeutic effect and improved the symptoms in patients with perimenopausal FD as assessed by the HRSD score, motilin and gastrin levels, and rate of gastric emptying. The total effective rate of the Xiaoyao pill in the treatment group was significantly superior to that of the placebo in the control group. In the control group, the initial HRSD score was 12.12 ± 2.29 and decreased to 7.14 ± 1.67 after therapy (P < 0.01). In the treatment group, the initial HRSD score was 11.44 ± 2.15, which significantly decreased to 6.20 ± 2.08 after therapy (P < 0.01). Moreover, the HRSD score in the treatment group was significantly lower than in control group after 8 wk (P < 0.01). Motilin and gastrin levels in both groups were significantly increased after the 8-wk therapy (P < 0.05). The gastric emptying rate was also improved in both groups after therapy (P < 0.05), and the improvement was significantly better in the treatment group compared to the controls (P < 0.05). These results confirm the therapeutic effects of the Xiaoyao pill in perimenopausal FD patients and indicate that it is worthy of clinical promotion.

CONCLUSION: The Xiaoyao pill is effective and safe for the treatment of perimenopausal women with FD associated with depression.

 

Efficacy and Safety of Modified Banxia Xiexin Decoction (Pinellia Decoction for Draining the Heart) for Gastroesophageal Reflux Disease in Adults: A Systematic Review and Meta-Analysis.

A study examining the effects of a modified ancient formula Ban Xia Xie Xin Tang (more properly translated as “Pinellia Drain the Epigastrium Decoction”) determined that “This systematic review indicates that MBXD may have potential effects on the treatment of patients with GERD.”

Evid Based Complement Alternat Med. 2017;2017:9591319. doi: 10.1155/2017/9591319. Epub 2017 Feb 19.

Dai Y, Zhang Y, Li D, Ye J, Chen W, Hu L.

Modified Banxia Xiexin decoction (MBXD) is a classical Chinese herbal formula used to treat gastroesophageal reflux disease (GERD) for a long time, but the efficacy of it is still controversial. This study is to evaluate the efficacy and safety of MBXD for the treatment of GERD in adults. The search strategy was carried out for publications in seven electronic databases. RevMan software version 5.3 and the Cochrane Collaboration’s risk of bias tool were performed for this review. Twelve RCTs were included for the analysis. The results of overall clinical efficacy and efficacy under gastroscope demonstrated that MBXD was superior to conventional western medicine. Meanwhile, the results of subgroup analysis showed clinical heterogeneity between the two groups. However, there was no statistically significant difference in acid regurgitation between the two groups. But in the improvement of heartburn and sternalgia, the results showed statistically significant differences for the comparison between two groups. In addition, the adverse reactions of the experiment groups were not different from those of the control groups. This systematic review indicates that MBXD may have potential effects on the treatment of patients with GERD. But because the evidence of methodological quality and sample sizes is weak, further standardized researches are required.

 

Changes in Esophageal Motility after Acupuncture.

“Verum acupuncture at Zusanli ST-36, but not sham, was observed to significantly decrease lower esophageal sphincter (LES) resting pressure…”

J Gastrointest Surg. 2017 Aug;21(8):1206-1211.

Electro-acupuncture (EA) at Zusanli ST-36 can affect oesophageal motility, report Brazilian investigators. Sixteen healthy volunteers underwent an oesophageal function test using high-resolution manometry. The test was performed in three phases: basal measurements, and 20 min after acupuncture stimulation of either Zusanli ST-3, or a sham point (five centimetres medial to ST-36), in a crossover design. The results showed that both verum and sham acupuncture resulted in a subtle change in the wave velocity of the oesophageal contraction pattern. Verum acupuncture at Zusanli ST-36, but not sham, was observed to significantly decrease lower esophageal sphincter (LES) resting pressure, suggesting a potential therapeutic role for EA in the treatment of conditions involving oesophageal spasticity.

 

Yinchenhao decoction in the treatment of cholestasis: A systematic review and meta-analysis.

In a study of another ancient formula for the treatment of cholestasis (a condition where bile cannot flow from the liver to the duodenum), the authors found: “This meta-analysis provides evidence that Yinchenhao decoction is an effective and safe treatment for cholestasis.”

J Ethnopharmacol. 2015 Jun 20;168:208-16. doi: 10.1016/j.jep.2015.03.058. Epub 2015 Apr 4.

Chen Z, Ma X, Zhao Y, Wang J, Zhang Y, Li J, Wang R, Zhu Y, Wang L, Xiao X.

ETHNOPHARMACOLOGICAL RELEVANCE: Yinchenhao decoction, a well-known Chinese herbal formula, has been widely used in Chinese Medicine for thousands of years. However, no systematic review of Yinchenhao decoction in treating cholestasis has been completed. This study aims to evaluate the efficacy and safety of the Yinchenhao decoction in treating cholestasis.

MATERIALS AND METHODS: The major databases (PubMed, Embase, Cochrane Library, Chinese Biomedical Database, Wanfang database, VIP medicine information system and China National Knowledge Infrastructure) were searched from the databases’ inception through November 2014. Randomized controlled trials (RCTs) of Yinchenhao decoction reported in publications for treatment of cholestasis were extracted by two reviewers. The RCTs examined included total efficacy rate and biochemical indices including alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL) and direct bilirubin (DBIL). The Cochrane tool was applied to assess the risk of bias of the trials. The main outcomes of the trials were analyzed using Review Manager 5.3 software. The odds ratio (OR) or mean difference (MD) with a 95% confidence interval (CI) was used to measure the effect.

RESULTS: Among the 698 studies identified in the literature search, 15 studies involving 1405 subjects with cholestasis were included in the analysis. Yinchenhao decoction demonstrated efficacy in cholestasis treatment whether in a combined application or not. Additionally, the decoction significantly reduced the elevated levels of cholestasis serum markers, such as ALT, AST, TBIL and DBIL, with a significant difference observed in short and long curative time periods. Remarkably, Yinchenhao decoction displayed a significant efficacy in treating the long-term disease.

CONCLUSION: No serious adverse event was reported. This meta-analysis provides evidence that Yinchenhao decoction is an effective and safe treatment for cholestasis.

 

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