{"title":"Herbal and Natural Products for NSAID-Induced Small Intestinal Injury: a systematic review and meta-analysis of randomized controlled trials.","authors":"Ji Hye Hwang, You-Kyung Choi","doi":"10.3831/KPI.2026.29.3.259","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin, are widely used medications that frequently cause small intestinal injury (enteropathy). Conventional proton pump inhibitors do not prevent this injury and may exacerbate it through dysbiosis. Herbal medicines and natural products offer potential therapeutic benefits, but synthesized clinical evidence remains limited. Thus, this study will systematically evaluate the efficacy and safety of herbal medicines and natural products for preventing NSAID-induced small intestinal injury.</p><p><strong>Methods: </strong>MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, and the China National Knowledge Infrastructure will be searched to identify articles published since inception, without restrictions on publication date or language. Randomized controlled trials involving adults aged ≥ 18 years receiving NSAIDs will be included. Two reviewers will independently perform study selection, data extraction, and risk-of-bias assessment using the RoB 2 tool. If appropriate, a meta-analysis will be conducted. The primary outcome will be mucosal injury, objectively assessed using video capsule endoscopy or measures of intestinal permeability. Secondary outcomes will include symptoms and adverse events.</p><p><strong>Results: </strong>This study will synthesize the current clinical evidence on natural interventions for NSAID-induced enteropathy.</p><p><strong>Conclusion: </strong>The findings will inform the management of small intestinal injury and guide future research.</p>","PeriodicalId":16769,"journal":{"name":"Journal of Pharmacopuncture","volume":"29 3","pages":"259-265"},"PeriodicalIF":1.5000,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13620395/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Pharmacopuncture","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3831/KPI.2026.29.3.259","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: Nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin, are widely used medications that frequently cause small intestinal injury (enteropathy). Conventional proton pump inhibitors do not prevent this injury and may exacerbate it through dysbiosis. Herbal medicines and natural products offer potential therapeutic benefits, but synthesized clinical evidence remains limited. Thus, this study will systematically evaluate the efficacy and safety of herbal medicines and natural products for preventing NSAID-induced small intestinal injury.
Methods: MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, and the China National Knowledge Infrastructure will be searched to identify articles published since inception, without restrictions on publication date or language. Randomized controlled trials involving adults aged ≥ 18 years receiving NSAIDs will be included. Two reviewers will independently perform study selection, data extraction, and risk-of-bias assessment using the RoB 2 tool. If appropriate, a meta-analysis will be conducted. The primary outcome will be mucosal injury, objectively assessed using video capsule endoscopy or measures of intestinal permeability. Secondary outcomes will include symptoms and adverse events.
Results: This study will synthesize the current clinical evidence on natural interventions for NSAID-induced enteropathy.
Conclusion: The findings will inform the management of small intestinal injury and guide future research.
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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