Clinical Efficacy and Safety of Yukgunja-tang for Gastroesophageal Reflux Disease: A Systematic Review and Meta-Analysis

Modified Banxia Xiexin decoction (MBXD) is a classical Chinese herbal formula in treating gastroesophageal reflux disease (GERD) for 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.

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Retracted: Randomised clinical trial: the clinical efficacy and safety of an alginate-antacid (Gaviscon Double Action) versus placebo, for decreasing upper gastrointestinal symptoms in symptomatic gastroesophageal reflux disease (GERD) in China

Alimentary Pharmacology & Therapeutics ◽

10.1111/apt.13334 ◽

2015 ◽

Vol 42 (7) ◽

pp. 845-854 ◽

Cited By ~ 20

Author(s):

J. Sun ◽

C. Yang ◽

H. Zhao ◽

P. Zheng ◽

J. Wilkinson ◽

...

Keyword(s):

Clinical Trial ◽

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Clinical Efficacy ◽

Reflux Disease ◽

Gastrointestinal Symptoms ◽

Randomised Clinical Trial ◽

Efficacy And Safety ◽

Upper Gastrointestinal Symptoms ◽

Upper Gastrointestinal

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675 FUNDOPLICATION VERSUS ORAL PROTON PUMP INHIBITORS FOR GASTROESOPHAGEAL REFLUX DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CLINICAL TRIALS

Diseases of the Esophagus ◽

10.1093/dote/doab052.675 ◽

2021 ◽

Vol 34 (Supplement_1) ◽

Author(s):

Luca Schiliró Tristão ◽

Francisco Tustumi ◽

Guilherme Tavares ◽

Letícia Nogueira Datrino ◽

Maria Carolina Andrade Serafim ◽

...

Keyword(s):

Systematic Review ◽

Clinical Trials ◽

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Adverse Events ◽

Proton Pump ◽

Reflux Disease ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Oral Intake

Abstract Gastroesophageal reflux disease (GERD) is a widely studied and highly prevalent condition. However, few is reported about the exact efficacy and safety of fundoplication (FPT) compared to oral intake proton-pump inhibitors (PPI). This systematic review and meta-analysis of randomized clinical trials (RCT) aims to compare PPI and FPT in relation to the efficacy, as well as the adverse events associated with these therapies. Methods This systematic review was guided by PRISMA statement. Search carried out in June 2020 was conducted on Medline, Cochrane, EMBASE and LILACS. The inclusion criteria were (I) patients with GERD; (II) Randomized clinical trials, comparing oral intake PPI with FPT; (III) relevant outcomes for this review. The exclusion criteria were (I) reviews, case reports, editorials and letters (II) transoral or endoscopic FPT (III) studies with no full text. No restrictions were set for language or period. Certainty of evidence and risk of bias were assessed with GRADE Pro and with Review Manager Version 5.4 bias assessment tool. Results Ten RCT were included. Meta-analysis showed that heartburn (RD = −0.19; 95% CI = −0.29, −0.09) was less frequently reported by patients that underwent FPT. Furthermore, patients undergoing surgery had greater pressure on the lower esophageal sphincter than those who used PPI (MD = 7.81; 95% CI 4.79, 10.83). There was no significant difference between groups in the percentage of time with pH less than 4 in 24 hours, sustained remission and Gastrointestinal Symptom Rating Scale. Finally, FPT did not increase significantly the risk for adverse events such as postoperative dysphagia and impaired belching. Conclusion FPT is a more effective therapy than PPI treatment for GERD, without significantly increasing the risk for adverse events. However, before indicating a possible surgical approach, it is extremely important to correctly assess and select the patients who would benefit from FPT, such as those with severe erosive esophagitis, severe respiratory symptoms, low adherence to continuous drug treatment and patients with non-acid reflux, to ensure better results.

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THE EFFICACY OF THE DIFFERENT ENDOSCOPIC TREATMENTS VERSUS SHAM, PHARMACOLOGIC OR SURGICAL METHODS FOR CHRONIC GASTROESOPHAGEAL REFLUX DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS

Arquivos de Gastroenterologia ◽

10.1590/s0004-2803.201800000-65 ◽

2018 ◽

Vol 55 (3) ◽

pp. 296-305 ◽

Cited By ~ 4

Author(s):

Martin Andrés CORONEL ◽

Wanderley Marques BERNARDO ◽

Diogo Turiani Hourneaux de MOURA ◽

Eduardo Turiani Hourneaux de MOURA ◽

Igor Braga RIBEIRO ◽

...

Keyword(s):

Systematic Review ◽

Surgical Treatment ◽

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Reflux Disease ◽

Meta Analysis ◽

Short Term ◽

Significant Difference ◽

Objective Outcomes

ABSTRACT BACKGROUND: Endoscopic antireflux treatments for gastroesophageal reflux disease (GERD) are still evolving, and most of the published studies address symptom relief in the short-term. Objective - We aimed to perform a systematic review and meta-analysis focused on evaluating the efficacy of the different endoscopic procedures. METHODS: Search was restricted to randomized controlled trials (RCTs) on MedLine, Cochrane, SciELO, and EMBASE for patients with chronic GERD (>6 months), over 18 years old and available follow up of at least 3 months. The main outcome was to evaluate the efficacy of the different endoscopic treatments compared to sham, pharmacological or surgical treatment. Efficacy was measured by different subjective and objective outcomes. RESULTS: We analyzed data from 16 RCT, totaling 1085 patients. The efficacy of endoscopic treatments compared to sham and proton pump inhibitors (PPIs) treatment showed a significant difference up to 6 months in favor of endoscopy with no heterogeneity (P<0.00001) (I2: 0%). The subgroup analysis showed a statistically significant difference up to 6 months in favor of endoscopy: endoscopy vs PPI (P<0.00001) (I2: 39%). Endoscopy vs sham (P<0.00001) (I2: 0%). Most subjective and objective outcomes were statistically significant in favor of endoscopy up to 6 and 12 months follow up. CONCLUSION: This systematic review and meta-analysis shows a good short-term efficacy in favor of endoscopic procedures when comparing them to a sham and pharmacological or surgical treatment. Data on long-term follow up is lacking and this should be explored in future studies.

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Epidemiology of gastroesophageal reflux disease in Iran: a systematic review and meta-analysis

BMC Gastroenterology ◽

10.1186/s12876-020-01417-6 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Mohammad Karimian ◽

Hassan Nourmohammadi ◽

Majid Salamati ◽

Mohammad Reza Hafezi Ahmadi ◽

Fatemeh Kazemi ◽

...

Keyword(s):

Systematic Review ◽

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Health Care Providers ◽

Reflux Disease ◽

Meta Analysis ◽

Iranian Population ◽

Cochrane Library ◽

Care Providers ◽

Online Databases

Abstract Background Gastroesophageal reflux disease (GERD), which leads to acid reflux into the esophagus, is a common gastrointestinal disorder. Several studies have shown the prevalence of GERD in Iranian population, but their evidence is contradictory. Therefore, the present study was conducted to investigate the epidemiology of GERD in Iran. Methods The entire steps of this systematic review and meta-analysis were based on the MOOSE protocol, and the results were reported accordance with the PRISMA guideline. This review is registered on PROSPERO (registration number: CRD42020142861). To find potentially relevant published articles, comprehensive search was done on international online databases Scopus, Science Direct, EMBASE, PubMed/Medline, CINAHL, EBSCO, Cochrane Library, Web of Science, Iranian online databases and the Google Scholar search engine in June 2019. Cochran test and I2 index were used to assess the heterogeneity of the studies. Data were analyzed using Comprehensive Meta-Analysis software ver. 2. The significance level of the test was considered to be P < 0.05. Results The daily, weekly, monthly, and overall prevalence of GERD symptoms in Iranian population was 5.64% (95%CI [confidence interval]: 3.77–8.35%; N = 66,398), 12.50% (95%CI: 9.63–16.08%; N = 110,388), 18.62% (95%CI: 12.90–26.12%; N = 70,749) and 43.07% (95%CI: 35.00–51.53%; N = 73,189), respectively. The daily, weekly, monthly, and overall prevalence of heartburn in Iranian population was 2.46% (95%CI: 0.93–6.39%; N = 18,774), 9.52% (95%CI: 6.16–14.41%; N = 54,125), 8.19% (95%CI: 2.42–24.30%; N = 19,363) and 23.20% (95%CI: 13.56–36.79%; N = 26,543), respectively. The daily, weekly, monthly, and overall prevalence of regurgitation in Iranian population was 4.00% (95%CI: 1.88–8.32%; N = 18,774), 9.79% (95%CI: 5.99–15.60%; N = 41,140), 13.76% (95%CI: 6.18–44.31%; N = 19,363) and 36.53% (95%CI: 19.30–58.08%; N = 21,174), respectively. The sensitivity analysis for prevalence of all types GERD, heartburn and regurgitation symptoms by removing a study showed that the overall estimate is still robust. Conclusion The present meta-analysis provides comprehensive and useful information on the epidemiology of GERD in Iran for policy-makers and health care providers. This study showed a high prevalence of GERD in Iran. Therefore, effective measures on GERD-related factors such as lifestyle can be among the health policies of Iran.

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