Clinical Evidence and Potential Mechanisms of Traditional Chinese Medicine for the Treatment of Chronic Gastritis: An Updated Systematic Review and Meta-analysis

Introduction: Classic formulas of traditional Chinese medicine (TCM) have been used for digestive diseases for more than 1 000 years. To determine whether TCM formulas used in modern clinical activities were effective to treat chronic gastritis (CG), we assessed the clinical evidence and potential mechanisms of TCM supplemental treatment on stable CG patients through a systematic review and meta-analysis of clinical trials. Methods: Relevant studies were identified by searching for papers published from January 2005 to August 2022 in the following databases: Cochrane Library, PubMed, and EMBASE, China National Knowledge Infrastructure, Wan Fang Database, and Chinese Scientific Journals Database, without language restrictions. The authors of the identified papers were contacted for additional information if necessary. Results: A total of 2 215 CG participants from 30 clinical randomised controlled trials of chronic superficial gastritis, chronic atrophic gastritis, chronic bile reflux gastritis, and chronic erosion gastritis were published in recent years. This meta-analysis showed that TCM could significantly alleviate the clinical symptoms and curative effects of chronic gastritis patients. Furthermore, the mechanisms of single- and two-medicinal combinations and the formula of the included studies are also summarised. Conclusions: The methodological quality of the included randomised controlled trials may limit the conclusions that indicate that TCM could alleviate the clinical symptoms and promising curative effect of CG patients; some further rigorous designed and well-conducted research should be needed.