Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore and Gleneagles Hospital, Singapore City, Singapore.
Faculty of Medicine & Faculty of Health & Behavioural Sciences, University of Queensland and Department of Gastroenterology & Hepatology, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.
Neurogastroenterol Motil. 2021 Feb;33(2):e14044. doi: 10.1111/nmo.14044. Epub 2020 Nov 30.
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.
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.
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.
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.
功能性消化不良的现代治疗方法存在局限性。草药被认为是一种辅助治疗方法。随着科学认识的提高和公众兴趣的增加，及时对其进行深入审查是必要的。
目的/目的：评估草药在功能性消化不良中的治疗潜力和可能存在的问题。
我们回顾了功能性消化不良的治疗现状，并评估了科学界对草药的兴趣。对市场上几种草药的临床前药理学和临床试验数据进行了审查。对草药在主流医学中应用所面临的挑战进行了批判性评估。
我们发现，草药通常由多种草药组成，这些草药对胃肠道运动和分泌功能以及细胞保护和精神作用具有多种报道的药理学作用。我们确定了一些经过严格临床试验的商业上可获得的草药产品，这些产品涉及大量明确界定的受试者，报告了功能性消化不良的疗效和安全性。持续存在的问题包括对大多数产品缺乏严格评估、毒性、成分一致性、剂量标准化和质量控制。我们提供了一个质量评估框架。
我们称赞草药作为治疗功能性消化不良的可行未来选择。草药的一个吸引人的吸引力是同时针对多种病理生理机制的前景。在功能性消化不良的治疗方案中更广泛地采用和接受草药将需要将化学疗法所期望的科学严谨性应用于其开发和评估的所有阶段。
