Treatment of chronic atrophic gastritis with Chinese medicines: a systematic review

AIM:To systematically evaluate the efficacy and safety of traditional Chinese medicines and Western medicines in the treatment of chronic atrophic gastritis.METHODS:The randomized clinical trials (RCTs) that compared the efficacy or safety of traditional Chinese medicines and Western medicines in the treatment of chronic atrophic gastritis were retrieved by searching Cochrane library, PubMed, OVID, CNKI, and VIP Chinese Scientific and Technological Periodical Database. Trials were considered to be of high quality if the Jaded scale score was 3 or more. Statistical heterogeneity between trials was evaluated using Revman 4.2. Heterogeneity of the included articles was tested to select proper effect models for calculation. Publication bias was investigated through visual inspection of funnel plots and Egger's regression model.RESULTS:Eight RCTs including 804 patients were analyzed. Compared with Western medicine group, Chinese medicines significantly improved excellent response rate, overall response rate, pathological symptoms (atrophy, intestinal metaplasia, and dysplasia) and adverse effects, and the total odd ratios (OR) were 4.17 [95% confidence interval (CI): 2.32-7.52], 5.79 (95%CI: 4.09-8.21), 5.06 (95%CI: 2.83-9.08), 5.67 (95%CI: 2.74-11.73), 4.72 (95%CI: 1.93-11.51), and 0.20 (95%CI: 0.09-0.47), respectively. No significant difference was noted in the total OR of negative conversion of Helicobacter pylori infection between the two groups (P＞0.05).Inspection of the funnel plots for all outcome measures did not reveal evidence of publication bias (P=0.781, 0.791, 0.702, 0.645, 0.593 and 0.779, respectively).CONCLUSION:Chinese medicines are superior to Western medicines in improving excellent response rate, overall response, and pathological symptoms and adverse effects in patients with chronic atrophy gastritis.