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Abstract

A peptic ulcer (PU) is a digestive disorder most commonly found in clinical practice. An oriental herbal formula, Xiao Chai Hu Tang (XCHT), has been used to treat PU for an extended period in China. The effectiveness and safety of XCHT in treating peptic ulcers was evaluated using a systematic review of randomized controlled trials (RCTs). Studies were systematically retrieved from CNKI, Embase, Medline, PubMed, SinoMed, VIP, Wanfang, and Web of Science. The following information was extracted from the relevant RCTs: the clinical efficacy rate, recurrence rate, clinical efficacy of traditional Chinese medicine, and the adverse effects. 13 RCTs, including 1334 patients, were included in this review. The meta-analysis showed that treatment with XCHT was superior to conventional pharmacotherapy (CPT) in improving the clinical efficacy rate (RR: 1.20, 95% confidence intervals (CIs): 1.08-1.34, P=0.0007), poor appetite (RR: 0.30, 95% CI: 0.15-0.61, P=0.0009), abdominal distension (RR: 0.61, 95% CI: 0.39-0.96, P=0.03), vomiting (RR: 0.33, 95% CI: 0.19-0.55, P < 0.0001), and stomach pain (RR: 0.36, 95% CI: 0.19-0.68, P=0.002) and reducing adverse events (RR: 0.23, 95% CI: 0.07-0.69, P=0.009). XCHT considerably increased the total clinical efficacy rate (RR: 1.22, 95% CI: 1.15-1.30, P < 0.00001) as both monotherapy and adjunctive therapy. The recurrence rate (RR = 0.29; 95% CI: 0.16-0.52, P < 0.0001) was remarkably decreased in the XCHT plus CPT group. The meta-analysis did not show a significant beneficial effect of XCHT compared with CPT in reducing the recurrence rate (RR = 0.45; 95% CI: 0.07-3.10, P=0.42) and acid reflux (RR: 0.76, 95% CI: 0.47-1.23, P=0.26). Our findings show that XCHT can treat peptic ulcers as part of an alternative medicine approach.

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Conflict of interest statement

The authors declare that there are no conflicts of interest regarding the publication of this paper.

Figures

Figure 1

Figure 1

PRISMA flowchart detailing the data…

Figure 1

PRISMA flowchart detailing the data identification, screening, eligibility, and inclusion.

Figure 1 PRISMA flowchart detailing the data identification, screening, eligibility, and inclusion.
Figure 2

Figure 2

Risk of bias summary.

Figure 2

Risk of bias summary.

Figure 2 Risk of bias summary.
Figure 3

Figure 3

Risk of bias graph.

Figure 3

Risk of bias graph.

Figure 3 Risk of bias graph.
Figure 4

Figure 4

Meta-analysis of the clinical efficacy…

Figure 4

Meta-analysis of the clinical efficacy rate of (a) XCHT and (b) XCHT +…

Figure 4 Meta-analysis of the clinical efficacy rate of (a) XCHT and (b) XCHT + CPT.
Figure 5

Figure 5

Meta-analysis of the recurrence rate…

Figure 5

Meta-analysis of the recurrence rate of (a) XCHT and (b) XCHT + CPT.

Figure 5 Meta-analysis of the recurrence rate of (a) XCHT and (b) XCHT + CPT.
Figure 6

Figure 6

Meta-analysis on the clinical efficacy…

Figure 6

Meta-analysis on the clinical efficacy of TCM symptoms. (a–e) show the comparisons and…

Figure 6 Meta-analysis on the clinical efficacy of TCM symptoms. (a–e) show the comparisons and meta-analysis results on the clinical efficacy of TCM symptoms between the XCHT and CPT groups. (a) Poor appetite. (b) Distention. (c) Vomit. (d) Stomach pain. (e) Acid reflux.
Figure 7

Figure 7

Meta-analysis on adverse events of…

Figure 7

Meta-analysis on adverse events of (a) XCHT and (b) XCHT + CPT.

Figure 7 Meta-analysis on adverse events of (a) XCHT and (b) XCHT + CPT.
All figures (7) See this image and copyright information in PMC

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