SYSTEMATIC REVIEW article
Front. Pharmacol.
Sec. Ethnopharmacology
Effect of Sihogyeji-tang on functional dyspepsia: A systematic review and meta-analysis
Provisionally accepted
- 1Pusan National University - Yangsan Campus, Yangsan-si, Republic of Korea
- 2Kyung Hee University Medical Center, Dongdaemun-gu, Republic of Korea
- 3Pusan National University Korean Medicine Hospital, Yangsan, Republic of Korea
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Introduction: Functional dyspepsia (FD) has a global prevalence of approximately 15% and is characterized by chronic symptoms with an unclear etiology. Herbal medicines, owing to their multifaceted mechanisms, are promising therapeutic options for FD. This study aimed to establish medical evidence for the use of Sihogyeji-tang (SG), a herbal medicine, in the treatment of FD, thereby providing clinically relevant evidence for both patients and healthcare practitioners. Methods: A comprehensive search was conducted on June 24, 2025, in the following databases— four English databases (CINAHL, EMBASE, Cochrane Database, and PubMed), five Korean databases (RISS, KISS, NDSL, DBPIA, and OASIS), one Japanese database (J-Stage), and three Chinese databases (CNKI, Wanfang, and VIP)—to identify eligible studies for this review. Randomized controlled trials investigating the use of SG for the treatment of FD were included. The risk of bias was assessed using the Cochrane Risk of Bias tool and the results were synthesized with Review Manager 5.4. This is a provisional file, not the final typeset article Results: Data from 12 randomized controlled trials involving 805 individuals were included in the meta-analysis. SG demonstrated a significantly higher total effective rate than prokinetic agents (risk ratio [RR]: 1.28, 95% confidence interval [CI]: 1.19–1.37, P < 0.00001). SG also resulted in a significantly greater reduction in symptom severity, as measured by the traditional Chinese medicine (TCM) symptom total score, compared with the control group (standardized mean difference: -1.10, 95% CI: -1.53 to -0.68, P < 0.00001). The incidence of adverse events was significantly lower in the SG group than in the control group (RR: 0.26, 95% CI: 0.09–0.76, P < 0.05). The quality of evidence was rated as moderate for the total effective rate, very low for the TCM symptom score, and low for adverse events. Discussion: The findings suggest that SG may be more effective and safer than prokinetic agents for FD. However, the certainty of the evidence is limited by methodological weaknesses in the included studies. To validate these results and support the clinical adoption of SG in FD, robust and extensive randomized controlled trials are needed. Systematic review registration: [https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD420251041781].
Keywords: Sihogyeji-tang, Chaihu Guizhi Decoction, Herbal Medicine, functional dyspepsia, Systematic review, Meta-analysis
Received: 21 Aug 2025; Accepted: 10 Nov 2025.
Copyright: © 2025 Bae, Kim and Kim. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Soyeon Kim, kimsy@pusan.ac.kr
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