Therapeutic effect and safety of Wei-Fu-Chun in the treatment of Chronic Atrophic gastritis: A network meta-analysis

Yunbo WuLing Hu^*

• Spleen and Stomach Research Institute, Guangzhou University of Chinese Medicine, Guangzhou, China

Introduction: Chronic atrophic gastritis (CAG) is a chronic condition characterized by a reduction in gastric mucosal glands and is often regarded as a precursor to gastric cancer. Currently, Western medicine lacks specific treatments for CAG, with management primarily focusing on symptomatic relief and, in cases involving Helicobacter pylori infection, eradication therapy. This study employs a network meta-analysis (NMA) to evaluate the efficacy and safety of the Chinese patent medicine Wei-Fu-Chun (WFC) in the treatment of CAG. Methods: We systematically reviewed randomized controlled trials (RCTs) comparing WFC with other interventions for CAG. Outcomes assessed included clinical effectiveness, gastrointestinal symptom scores, gastrointestinal hormone levels, and adverse reactions. The quality of the included studies was assessed with the Cochrane Handbook and GRADEpro software . Risk ratios were calculated for dichotomous outcomes, and standardized mean differences with 95% confidence intervals were used for continuous variables. Funnel plots were generated to assess publication bias, and treatments were ranked using the surface under the cumulative ranking curve (SUCRA). Data analysis was performed using STATA 15.0 and Review Manager 5.3. The protocol has been registered with PROSPERO under the registration number CRD420251056533. Results: A total of 38 RCTs involving 3,844 participants were included and 10 interventions were enrolled: Convention therapy, prokinetics, mucosal protective agents (MPA), acid suppressed drugs (ASD), H. pylori eradication therapy (HET), 2 WFC, WFC + Prokinetics, WFC + MPA, WFC + ASD, WFC + HET. The NMA results indicated that WFC combined with MPA ranked highest in overall clinical efficacy, while WFC combined with prokinetics was most effective in restoring gastrin/motilin levels and alleviating symptom burden. WFC monotherapy also outperformed several Western medications (e.g., MPA, acid inhibitors, and conventional therapy) across multiple outcomes. Combinations of WFC with acid suppressants or prokinetics were associated with fewer adverse events compared to monotherapies, suggesting a potential reduction in drug-related side effects. Conclusion: WFC, particularly in combination with Western medications, enhances clinical efficacy and reduces the incidence of adverse events in patients with CAG. These findings support its potential as a therapeutic option for improving clinical outcomes in CAG