A systematic review of treating Helicobacter pylori infection with Traditional Chinese Medicine.
OBJECTIVE
To evaluate the efficacy and safety of Traditional Chinese Medicine (TCM) in the treatment of Helicobacter pylori (H. pylori) infection.


METHODS
We electronically and manually searched electronic databases, references lists and conferences compilations, and included all randomized clinical trials comparing the treatment of H. pylori using TCM with proton pump inhibitor or colloidal bismuth subcitrate-based triple therapy as controls. The Jadad score was used to assess trial quality, H. pylori eradication rate and the incidence of side effects were taken as outcome measurements, and heterogeneity analysis, meta-analysis and funnel plot analysis were conducted.


RESULTS
Sixteen trials were included. The Jadad scores of all the trials were not more than 2. Clinical heterogeneity and substantial statistical heterogeneity existed among the trials (P = 0.001, I(2) = 59%) and meta-analysis was not conducted. The average eradication rates following TCM and triple therapy were 72% and 78% and the incidence of side effects were 2% and 29%, respectively. The funnel plot was obviously asymmetric.


CONCLUSIONS
Available evidence is not convincing enough to show that TCM has the same efficacy as triple therapy in H. pylori treatment. TCM may be safer than triple therapy. TCM should not be recommended as monotherapy in H. pylori infection.
Department of Gastroenterology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200021, China. lin_jiang@hotmail.com
Jiang
J
Lin
Wei-Wen
WW
Huang
D004359:Drug Therapy, Combination; D004365:Drugs, Chinese Herbal / Q000009:adverse effects / Q000627:therapeutic use*; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D008516:Medicine, Chinese Traditional / Q000009:adverse effects; D009942:Organometallic Compounds / Q000627:therapeutic use; D008517:Phytotherapy; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
D004365:Drugs, Chinese Herbal; D009942:Organometallic Compounds; D054328:Proton Pump Inhibitors; C002791:bismuth tripotassium dicitrate