Systematic Reviews
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 7, 2022; 28(33): 4890-4908
Published online Sep 7, 2022. doi: 10.3748/wjg.v28.i33.4890
Chinese herbal formula shen-ling-bai-zhu-san to treat chronic gastritis: Clinical evidence and potential mechanisms
Wei Jin, Juan Zhong, Yang Song, Ming-Fei Li, Shi-Yi Song, Chun-Run Li, Wei-Wei Hou, Qing-Jie Li
Wei Jin, Yang Song, Ming-Fei Li, Wei-Wei Hou, Department of Emergency, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610075, Sichuan Province, China
Juan Zhong, Shi-Yi Song, Chun-Run Li, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, Sichuan Province, China
Qing-Jie Li, Interventional Operation Room, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610075, Sichuan Province, China
Author contributions: Jin W and Zhong J designed the protocol; this work was conducted by Jin W, Zhong J, Li QJ, Song Y, and Hou WW; the manuscript was drafted by Zhong J and revised by Li MF, Song SY, and Li CR; Jin W and Zhong J contributed equally to this work and should be regarded as co-first authors; all authors approved the final manuscript before submission.
Conflict-of-interest statement: There are no conflicts of interest to report.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wei-Wei Hou, MD, PhD, Chief Doctor, Department of Emergency, Hospital of Chengdu University of Traditional Chinese Medicine, No. 39 Shierqiao Road, Chengdu 610075, Sichuan Province, China. houww2018@cdutcm.edu.cn
Received: January 12, 2022
Peer-review started: January 12, 2022
First decision: March 8, 2022
Revised: March 16, 2022
Accepted: August 6, 2022
Article in press: August 6, 2022
Published online: September 7, 2022
Abstract
BACKGROUND

Chronic gastritis (CG) is an inflammatory disease of the gastric mucosa. Shen-ling-bai-zhu san (SLBZS), a traditional Chinese medicine formula, is widely used for treating CG. Nevertheless, its effects are currently unclear.

AIM

To determine the clinical evidence and potential mechanisms of SLBZS for the treatment of CG.

METHODS

We systematically searched 3 English (PubMed, Embase, Medline) and 4 Chinese databases (Cochrane Library Central Register of Controlled Trials, China National Knowledge Infrastructure database, Wanfang Data Knowledge Service Platform, and the VIP information resource integration service platform) without language or publication bias restriction. Qualified studies were selected according to pre-set inclusion and exclusion criteria. RevMan 5.3 software was used for meta-analysis and literature quality assessment, Stata 14.0 software was used for sensitivity analysis, GRADE profiler 3.6 was used to evaluate the quality of evidence. And then, network pharmacology analysis was applied to primary research the mechanisms of action of SLBZS on CG.

RESULTS

Fourteen studies were finally included, covering 1335 participants. Meta-analysis indicated that: (1) SLBZS was superior to conventional therapies [risk ratio (RR): 1.29, 95% confidence interval (CI): 1.21 to 1.37, P < 0.00001]; (2) SLBZS was better than conventional therapies [RR: 0.24, 95% confidence interval (95%CI): 0.11 to 0.55, P = 0.0007] in terms of recurrence rate and reversal of Helicobacter pylori positivity (RR: 1.20, 95%CI: 1.11 to 1.30, P < 0.00001); and (3) The safety of SLBZS for CG remains unclear. According to the GRADE method, the quality of evidence was not high. Besides, SNZJS might treat CG by acting on related targets and pathways such as EGFR tyrosine kinase inhibitor resistance, the PI3K-Akt signaling pathway, and others.

CONCLUSION

SLBZS might be useful in treating CG, but long-term effects and specific clinical mechanisms of it maintain unclear. More samples and high-quality clinical experiments should be assessed and verified in the next step.

Keywords: Chronic gastritis, Shen-ling-bai-zhu-san, Chinese herbal formula, Systematic review, Network pharmacology

Core Tip: A 2012 clinical practice guideline recommended Shenling Baizhu Powder for the Pattern of Spleen and Stomach Deficiency chronic gastritis (CG). The 2020 clinical guideline did not recommended Shen-ling-bai-zhu san (SLBZS), possibly because of inadequate clinical evidence and pharmacological mechanisms. We designed our study to focus on evidence of efficacy and potential mechanisms. Our study showed that SLBZS might be useful in treating CG; however, its long-term effects and mechanisms of action are unclear. Due to the poor quality of the evidence, more samples and high-quality clinical studies should be tested.