Twelve Chinese patent medicines combined with conventional medicine for the treatment of functional dyspepsia: a network meta-analysis.

BACKGROUND

This study systematically evaluates the clinical efficacy and safety of 12 Chinese Patent Medicines (CPMs) combined with conventional Western medicine (CWM) in treating Functional Dyspepsia (FD), aiming to provide robust evidence for optimizing treatment strategies.

METHODS

We systematically searched eight Chinese and international databases up to September 2025, including China National Knowledge Infrastructure, Wanfang Data, VIP Information, China Biology Medicine Disc, PubMed, Embase, Web of Science, and the Cochrane Library. Risk of bias was assessed using the Cochrane tool, and evidence certainty was appraised with CINeMA. Network meta-analysis was performed within a frequentist framework using random-effects models, and treatments were ranked by the surface under the cumulative ranking curve (SUCRA).

RESULTS

A total of 76 RCTs involving 7,575 participants were included. All CPM + CWM regimens were more effective than CWM alone. The most significant benefit for total effective rate was observed with Jinghua Weikang Capsules (JWC) + CWM (RR = 1.46, 95% CI 1.28-1.67; SUCRA = 98.4%), Wuling Capsules (WLC) + CWM (RR = 1.29, 95% CI 1.18-1.42; SUCRA = 80.9%), and Qizhi Weitong Granules (QWG) + CWM (RR = 1.26, 95% CI 1.14-1.38; SUCRA = 69.2%). For motilin, WLC + CWM, Zhizhu Kuanzhong Capsules (ZKC) + CWM, and Simo Tang Oral Liquid (STOL) + CWM showed significant improvements. For gastrin, Liuwei Nengxiao Capsules (LNC) + CWM, Dalitong Granules (DLTG) + CWM, and STOL + CWM ranked highest. No CPM + CWM regimen was associated with a significant increase in adverse events, except for a higher risk with WLC + CWM versus QWG + CWM (OR = 4.82, 95% CI 1.02-22.87). Sensitivity analyses and meta-regression supported the robustness of these findings, while CINeMA rated the certainty of evidence as low for most comparisons.

CONCLUSION

CPM combined with CWM was more effective than CWM alone in improving symptom response and gastrointestinal hormone levels, without increasing adverse events. These findings support CPMs as promising adjuncts to standard therapy, though higher-quality RCTs are needed to confirm their role in personalized management of functional dyspepsia.

SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/ CRD42024562649.