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Chinese herbal medicine shows superior clinical efficacy and symptom relief compared to proton pump inhibitorsChinese Herbal Medicine Shows Better Results Than PPIs for GERD

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Key Takeaway
Consider Chinese herbal medicine as a potentially more effective alternative to PPIs for symptom relief in GERD.

This meta-analysis evaluated the efficacy of Chinese herbal medicine (CHM) compared to proton pump inhibitors (PPIs) in patients with gastroesophageal reflux disease. The analysis included a total sample size of 2,246 patients to determine the comparative effectiveness of these treatments.

The primary finding indicates that CHM was superior to PPIs for clinical efficacy, with an odds ratio of 4.13 (95% confidence interval: 2.73 to 6.25). Regarding secondary outcomes, CHM demonstrated superior symptom relief with a standard mean difference of 0.71 (95% confidence interval: 0.49 to 0.94). Additionally, lower recurrence rates were observed with CHM, though specific effect sizes for recurrence were not reported.

Safety profiles were reported as equivalent between the two interventions. The authors suggest that CHM may have clinical utility in strengthening the esophagogastric barrier and potentially reducing long-term dependence on proton pump inhibitors. However, specific limitations and certainty of evidence were not reported in the data.

How this fits prior evidence

This meta-analysis addresses a gap in management strategies for gastroesophageal reflux disease by comparing herbal interventions to standard acid suppression. While prior coverage noted that proton pump inhibitor use in pediatric patients is associated with reduced microbial diversity, this study explores an alternative to reduce long-term PPI dependence. The finding of superior clinical efficacy (odds ratio: 4.13) and symptom relief (standard mean difference: 0.71) for CHM provides a new perspective on non-pharmacological adjuncts for GERD.

Researchers analyzed data from 2,246 patients with gastroesophageal reflux disease (GERD) to compare traditional treatments. They looked at the effectiveness of Chinese herbal medicine (CHM) compared to proton pump inhibitors (PPIs), which are common medications used to manage acid reflux.

The findings showed that Chinese herbal medicine was more effective than PPIs for overall clinical success and symptom relief. Additionally, patients using the herbal treatments experienced lower rates of symptom recurrence. The study also noted that both treatment methods were considered to have similar safety profiles.

While these results are promising, it is important to remember that this was a meta-analysis of existing data. Because the study did not report specific side effects or long-term follow-up details, the evidence is not yet enough to change standard medical practices. Patients should talk to their doctor about how these findings might apply to their specific treatment plan.

What this means for you:
Chinese herbal medicine showed better symptom relief and lower recurrence than PPIs for acid reflux patients.

Common questions

Is Chinese herbal medicine more effective than standard acid reflux pills?

The study of 2,246 patients found that Chinese herbal medicine was superior to proton pump inhibitors for clinical efficacy and symptom relief. The data showed a significant difference in how well patients managed their symptoms compared to those taking standard medications.

Does herbal medicine help prevent acid reflux from coming back?

The results showed that patients using Chinese herbal medicine had lower recurrence rates than those using proton pump inhibitors. This suggests it may help keep symptoms away for longer periods.

Is it safe to use herbal medicine instead of my current medication?

The study reported that both Chinese herbal medicine and proton pump inhibitors had equivalent safety. However, you should consult your doctor before changing your treatment plan to ensure it is safe for your specific health needs.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedSep 2026
View Original Abstract ↓
BackgroundGastroesophageal reflux disease (GERD) is commonly treated with proton pump inhibitors (PPIs) despite their adverse effects and risk of recurrence. Chinese herbal medicine (CHM) has long been used to alleviate reflux-related symptoms and reduce relapse through multi-component and multi-target strategies. To evaluate the efficacy and safety of CHM for GERD and identify key botanical drugs contributing to therapeutic effects using a component-level analytical framework.MethodsEnglish and Chinese databases were screened for relevant articles up to 15 April 2026. Eligible randomized controlled trials (RCTs) compared CHM with biomedicine. A meta-analysis was performed using RevMan 5.4 software, and the risk of bias assessed using Cochrane Risk of Bias two tool. A component-level contribution analysis based on component network meta-analysis (CNMA) framework and core-pattern network analysis were used to quantify individual botanical drug contributions and co-prescription structures.ResultsTwenty randomized controlled trials involving 2,246 patients with GERD were included. Pairwise meta-analysis showed that CHM was superior to PPIs in clinical efficacy (odds ratio: 4.13, 95% confidence interval: 2.73–6.25) and symptom relief (standard mean difference: 0.71, 95% confidence interval: 0.49–0.94), with lower recurrence rates and equivalent safety. Network meta-analyses identified several CHM formulas with favorable effects relative to PPIs. Component-level contribution analyses identified varying associations among botanical drugs. Core-pattern analysis identified Pinelliae rhizoma as a highly connected botanical drug.ConclusionThis study presents the first component-level analysis of CHM prescriptions for GERD, suggesting improvements in clinical efficacy and recurrence control. By integrating prescription patterns with evidence-based pharmacology, our findings provide insights into multi-target CHM strategies and support the potential of CHM to strengthen the esophagogastric barrier and reduce long-term PPI dependence.Trial registrationThe study was registered on PROSPERO, registration number CRD42024612778.
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