Efficacy of Shugan Hewei Therapy for Chronic Atrophic Gastritis: A Systematic Review and Meta-Analysis

Abstract

Abstract Objective: Shugan Hewei therapy (SHT) acts to soothe the liver and harmonize the stomach. It is a classical traditional Chinese medicine method widely used in China to treat chronic atrophic gastritis (CAG) due to liver qi invading the stomach. However, the clinical effects of SHT remain unclear. We aimed to evaluate the overall clinical effective rate and safety of SHT in treating CAG. Methods: We used the Jadad scale and Cochrane Collaboration risk of bias tool to evaluate the methodological quality of studies investigating SHT. Eight medical databases were searched to identify relevant studies. After data extraction and quality evaluation, 27 randomized controlled trials, including 2,441 patients, were considered eligible for analysis. No serious heterogeneity or publication bias was observed across the included studies. We used Revman 5.3 statistical software to evaluate the general clinical effective rate and safety of SHT. Results: The results showed that SHT was more effective (RR=1.25; 95% CI [1.20, 1.29]; P<0.01) and safer (MD=0.24, 95% CI [0.08, 0.75]; P<0.01) than control interventions comprising western medicine, Chinese patent medicine, and/or western medicine + Chinese patent medicine. Compared with the control interventions, SHT resulted in greater improvements in the symptom scores for stomach distension and stomachache, serum gastrin level, histopathologic changes, Helicobacter pylori (HP) inhibition rate, and gastric mucosal inflammation. Conclusion: SHT was more effective and safer than control interventions for CAG.