{"title":"Herbal and Natural Product Interventions to Modulate Gut Microbiota in Acid Suppression-Associated Dysbiosis: a systematic review protocol.","authors":"Ji Hye Hwang, You-Kyung Choi","doi":"10.3831/KPI.2026.29.2.149","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Proton pump inhibitors are widely used to manage acid-related gastrointestinal disorders; however, prolonged use has been associated with gut dysbiosis, including reduced microbial diversity and the proliferation of opportunistic pathogens. Herbal medicines and natural products, characterized by multitarget effects, have been proposed as potential strategies for modulating the gut microbiota and restoring microbial homeostasis. This systematic review aims to evaluate the effects of these interventions on the gut microbiota in patients receiving acid suppression therapy.</p><p><strong>Methods: </strong>This protocol is registered in the PROSPERO international prospective register of systematic reviews (CRD420261346672) and will be conducted in accordance with the PRISMA-P guidelines. A comprehensive literature search will be performed in PubMed, Scopus, Web of Science, CENTRAL, and CNKI from database inception to March 2026. Randomized controlled trials and nonrandomized controlled clinical studies evaluating herbal or natural product interventions in adult patients receiving acid suppression therapy will be included. Two independent reviewers will perform study screening, data extraction, and risk-of-bias assessment using the RoB 2 and ROBINS-I tools. The overall certainty of the evidence will be evaluated using the GRADE approach.</p><p><strong>Results: </strong>Findings will be synthesized narratively, with a focus on taxonomic shifts (from the phylum to genus level) and diversity indices (alpha and beta diversity). Where sufficient data are available, a quantitative meta-analysis will be conducted using a random-effects model. Subgroup analyses will explore differences according to herbal intervention type (e.g., single extracts vs. multiherb formulations) and microbiome assessment methods.</p><p><strong>Conclusion: </strong>This review will provide a structured overview of the microbiota-modulating effects of herbal and natural product interventions during acid suppression therapy. By bridging traditional medicine and modern microbiome science, the findings may help inform integrative therapeutic strategies and guide the design of future high-quality clinical trials.</p>","PeriodicalId":16769,"journal":{"name":"Journal of Pharmacopuncture","volume":"29 2","pages":"149-154"},"PeriodicalIF":1.5000,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13303573/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Pharmacopuncture","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3831/KPI.2026.29.2.149","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"INTEGRATIVE & COMPLEMENTARY MEDICINE","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives: Proton pump inhibitors are widely used to manage acid-related gastrointestinal disorders; however, prolonged use has been associated with gut dysbiosis, including reduced microbial diversity and the proliferation of opportunistic pathogens. Herbal medicines and natural products, characterized by multitarget effects, have been proposed as potential strategies for modulating the gut microbiota and restoring microbial homeostasis. This systematic review aims to evaluate the effects of these interventions on the gut microbiota in patients receiving acid suppression therapy.
Methods: This protocol is registered in the PROSPERO international prospective register of systematic reviews (CRD420261346672) and will be conducted in accordance with the PRISMA-P guidelines. A comprehensive literature search will be performed in PubMed, Scopus, Web of Science, CENTRAL, and CNKI from database inception to March 2026. Randomized controlled trials and nonrandomized controlled clinical studies evaluating herbal or natural product interventions in adult patients receiving acid suppression therapy will be included. Two independent reviewers will perform study screening, data extraction, and risk-of-bias assessment using the RoB 2 and ROBINS-I tools. The overall certainty of the evidence will be evaluated using the GRADE approach.
Results: Findings will be synthesized narratively, with a focus on taxonomic shifts (from the phylum to genus level) and diversity indices (alpha and beta diversity). Where sufficient data are available, a quantitative meta-analysis will be conducted using a random-effects model. Subgroup analyses will explore differences according to herbal intervention type (e.g., single extracts vs. multiherb formulations) and microbiome assessment methods.
Conclusion: This review will provide a structured overview of the microbiota-modulating effects of herbal and natural product interventions during acid suppression therapy. By bridging traditional medicine and modern microbiome science, the findings may help inform integrative therapeutic strategies and guide the design of future high-quality clinical trials.
目的：质子泵抑制剂被广泛用于治疗酸相关性胃肠道疾病；然而，长期使用与肠道生态失调有关，包括微生物多样性减少和机会性病原体的增殖。草药和天然产物具有多靶点效应的特点，被认为是调节肠道微生物群和恢复微生物稳态的潜在策略。本系统综述旨在评估这些干预措施对接受抑酸治疗的患者肠道微生物群的影响。方法：该方案已在普洛斯彼罗国际前瞻性系统评价注册（CRD420261346672）中注册，并将按照PRISMA-P指南进行。全面检索PubMed、Scopus、Web of Science、CENTRAL和CNKI从建库到2026年3月的文献。将包括随机对照试验和非随机对照临床研究，评估接受抑酸治疗的成人患者的草药或天然产品干预措施。两名独立审稿人将使用rob2和ROBINS-I工具进行研究筛选、数据提取和偏倚风险评估。证据的总体确定性将使用GRADE方法进行评估。结果：研究结果将以叙述性的方式进行综合，重点是分类转变（从门到属水平）和多样性指数（α和β多样性）。如果有足够的数据，将使用随机效应模型进行定量荟萃分析。亚组分析将根据草药干预类型（例如，单一提取物与多草药配方）和微生物组评估方法探索差异。结论：本综述将对抑酸治疗中草药和天然产物干预的微生物群调节作用提供一个结构化的概述。通过将传统医学与现代微生物组科学联系起来，这些发现可能有助于为综合治疗策略提供信息，并指导未来高质量临床试验的设计。
期刊介绍：
The Journal of Pharmacopuncture covers a wide range of basic and clinical science research relevant to all aspects of the biotechnology of integrated approaches using both pharmacology and acupuncture therapeutics, including research involving pharmacology, acupuncture studies and pharmacopuncture studies. The subjects are mainly divided into three categories: pharmacology (applied phytomedicine, plant sciences, pharmacology, toxicology, medicinal plants, traditional medicines, herbal medicine, Sasang constitutional medicine, herbal formulae, foods, agricultural technologies, naturopathy, etc.), acupuncture (acupressure, electroacupuncture, laser acupuncture, moxibustion, cupping, etc.), and pharmacopuncture (aqua-acupuncture, meridian pharmacopuncture, eight-principles pharmacopuncture, animal-based pharmacopuncture, mountain ginseng pharmacopuncture, bee venom therapy, needle embedding therapy, implant therapy, etc.). Other categories include chuna treatment, veterinary acupuncture and related animal studies, alternative medicines for treating cancer and cancer-related symptoms, etc. Broader topical coverage on the effects of acupuncture, the medical plants used in traditional and alternative medicine, pharmacological action and other related modalities, such as anthroposophy, homeopathy, ayurveda, bioelectromagnetic therapy, chiropractic, neural therapy and meditation, can be considered to be within the journal’s scope if based on acupoints and meridians. Submissions of original articles, review articles, systematic reviews, case reports, brief reports, opinions, commentaries, medical lectures, letters to the editor, photo-essays, technical notes, and book reviews are encouraged. Providing free access to the full text of all current and archived articles on its website (www.journal.ac), also searchable through a Google Scholar search.
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