4.4 Review

Herbal medicines in functional dyspepsia-Untapped opportunities not without risks

期刊

NEUROGASTROENTEROLOGY AND MOTILITY
卷 33, 期 2, 页码 -

出版社

WILEY
DOI: 10.1111/nmo.14044

关键词

functional dyspepsia; gastrointestinal physiology; herbal medicine; pharmacology; toxicity; treatment algorithms

资金

  1. Xiyuan Hospital of China Academy of Chinese Medical Sciences under the Belt Road Initiative [2017YFC1703703]

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The therapeutic potential and challenges associated with the adoption of herbal medicines in functional dyspepsia were evaluated, with findings that herbal medicines often comprise a combination of herbs with multiple pharmacological effects but face concerns such as lack of rigorous assessments and quality control. A quality framework for evaluating herbal medicines was provided.
Background Contemporary treatments for functional dyspepsia have limitations. Herbal medicine has been suggested as adjunctive treatment. With growing scientific recognition and public interests, an in-depth review of this is timely. Aims/Purpose To evaluate the therapeutic potential and problems that may be associated with the adoption of herbal medicines in functional dyspepsia. Methods We reviewed the treatment landscape of functional dyspepsia and assessed the scientific community's interest in herbal medicine. Preclinical pharmacological and clinical trial data were reviewed for several herbal medicines available in the market. Challenges associated with adoption of herbal medicine in mainstream medicine were critically evaluated. Results We found that herbal medicines frequently comprise a combination of herbs with multiple reported pharmacological effects on gastrointestinal motility and secretory functions, as well as cytoprotective and psychotropic properties. We identified a number of commercially available herbal products that have undergone rigorous clinical trials, involving large numbers of well-defined subjects, reporting both efficacy and safety for functional dyspepsia. Persisting concerns include lack of rigorous assessments for majority of products, toxicity, consistency of ingredients, dose standardizations, and quality control. We provide a quality framework for its evaluation. Conclusions We commend herbal medicine as a viable future option in managing functional dyspepsia. An attractive appeal of herbal medicine is the prospect to simultaneously target multiple pathophysiological mechanisms. Wider adoption and acceptance of herbal medicines in treatment algorithms of functional dyspepsia will require the application of the scientific rigor expected of chemical therapies, to all stages of their development and evaluation.

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