Safety and efficacy of Xiaoyao-san for the treatment of functional dyspepsia: a systematic review and meta-analysis of randomized controlled trials

Objective: Although Xiaoyao-san (XYS) is a popular herbal remedy for indigestion, there is insufficient evidence to recommend it as a treatment option for functional dyspepsia (FD). This review aimed to assess the safety and efficacy of XYS in patients with FD, compared to conventional Western medicine (WM).Methods: Two independent reviewers searched for randomized controlled trials (RCTs) using 11 electronic databases, including Medline and Embase, to evaluate therapeutic effects of XYS on FD up to 31 January 2023. The primary outcome was the total clinical efficacy rate (TCE), and secondary outcomes included scores of dyspepsia-related symptoms (DSS) and incidence of adverse events (AEs). The risk of bias was evaluated using the Cochrane collaboration tool, and data synthesis and subgroup analyses were performed using the Review Manager program.Results: Six studies involving 707 participants were included in the meta-analysis. XYS significantly improved TCE compared to WM (RR = 1.15, 95% CI: 1.05, 1.26, p = 0.002) with high heterogeneity (I2 = 59%, p = 0.06). Combination therapy also showed higher TCE than WM alone (RR = 1.22, 95% CI: 1.05, 1.41, p = 0.008), and the heterogeneity was low (I2 = 0%, p = 0.86). The results showed a greater reduction in DSS in the XYS and combination therapy groups than in the WM alone group (SMD = −0.72, 95% CI: −0.90, −0.53, p < 0.00001) with low heterogeneity (I2 = 44%, p = 0.15), especially for abdominal distension and upper abdominal pain. AEs occurred less frequently in the XYS and combination therapy groups than in the WM alone group (RR = 0.20, 95% CI: 0.07, 0.63, p = 0.006), and the heterogeneity was low (I2 = 45%, p = 0.18). The certainty of the evidence for each outcome was rated from “very low” to “high.”Conclusion: This review suggests that XYS is effective and safe for reducing complaints in patients with FD. However, high-quality RCTs should be conducted to establish more convincing therapeutic evidence of XYS for the treatment of FD.Systematic Review Registration:https://www.crd.york.ac.uk/prospero, CRD4202017884

Realization of giant magnetoelectricity in helimagnets

We show that low field magnetoelectric (ME) properties of helimagnets Ba0.5Sr1.5Zn2(Fe1-xAlx)12O22 can be efficiently tailored by Al-substitution level. As x increases, the critical magnetic field for switching electric polarization is systematically reduced from ~1 T down to ~1 mT, and the ME susceptibility is greatly enhanced to reach a giant value of 2.0 x 10^4 ps/m at an optimum x = 0.08. We find that control of nontrivial orbital moment in the octahedral Fe sites through the Al-substitution is crucial for fine tuning of magnetic anisotropy and obtaining the conspicuously improved ME characteristics

Electric polarization enhancement in multiferroic CoCr2O4 crystals with Cr-site mixing

Single crystals of multiferroic cobalt chromite Co (Cr2-x Cox) O4 have been grown via several methods to have different Co3+ doping levels (x=0.0, 0.14, and 0.18). Under magnetic fields, all the crystals display electric polarization reversal below their spiral spin ordering temperatures. We find that both saturated electric polarization and magnetization under magnetic fields increase significantly with the increase in x. This result can be qualitatively explained by a broken balance between at least two electric polarization contributions existing in CoCr2 O4 and is expected to be useful in tailoring electric polarization in similar kinds of multiferroics. © 2009 American Institute of Physics.open222

Effects of a Herbal Medicine, Yukgunja-Tang, on Functional Dyspepsia Patients Classified by 3-Dimensional Facial Measurement: A Study Protocol for Placebo-Controlled, Double-Blind, Randomized Trial

Introduction. Functional dyspepsia (FD), a common upper gastrointestinal disease, is difficult to manage because of the limitations of current conventional treatments. Yukgunja-tang (YGJT) is widely used to treat FD in clinical practice in Korea, Japan, and China. However, YGJT significantly improves few symptoms of FD. In Korean medicine, FD is a well-known functional gastric disease that shows difference in the effect of herbal medicine depending on constitution or type of Korean medicine diagnosis. This study aims to investigate the efficacy of YGJT on FD patients classified by 3-dimensional facial measurement using a 3-dimensional facial shape diagnostic system (3-FSDS). Methods. A placebo-controlled, double-blind, randomized, two-center trial will be performed to evaluate the efficacy of YGJT on FD patients. Eligible subjects will be initially classified as two types by 3-dimensional facial measurement using the 3-FSDS. Ninety-six subjects (48 subjects per each type) will be enrolled. These subjects will be randomly allocated into treatment or control groups in a 2 : 1 ratio. YGJT or placebo will be administered to each group during the 8-week treatment period. The primary outcome is total dyspepsia symptom scale, and the secondary outcomes include single dyspepsia symptom scale, proportion of responders with adequate symptom relief, visual analog scale, Nepean dyspepsia index-Korean version, functional dyspepsia-related quality of life, and spleen qi deficiency questionnaire. Discussion. This is the first randomized controlled trial to assess the efficacy of the YGJT on FD patients classified by 3-dimensional facial measurement. We will compare the treatment effect of the YGJT on FD patients classified as two types using the 3-FSDS. The results of this trial will help the FD patients improve the symptoms and quality of life effectively and provide objective evidence for prescribing the YGJT to FD patients in clinical practice. Trial Registration. This trial is registered with Clinical Research Information Service Identifier: KCT0001920, 15 May, 2016

Effect of Korean Herbal Medicine Combined with a Probiotic Mixture on Diarrhea-Dominant Irritable Bowel Syndrome: A Double-Blind, Randomized, Placebo-Controlled Trial

Introduction. Although combination therapy with herbal medicine and probiotics is gaining popularity for controlling diarrheadominant irritable bowel syndrome (D-IBS) symptoms, few studies have investigated its clinical effects. Materials and Methods. Fifty-three patients with D-IBS were randomly allocated into 1 of the following 4 groups: herbal medicine (Gwakhyangjeonggisan; GJS) plus probiotics (Duolac7S; DUO), GJS plus placebo DUO, placebo GJS plus DUO, and placebo GJS plus placebo DUO. The study period consisted of a 2-week run-in, 8 weeks of administration, and 2 weeks of follow-up. The primary outcomes were weekly adequate relief (AR) of overall IBS symptoms and the proportion of responders (PR) during the administration period. The secondary outcomes included individual IBS symptoms, stool assessment, and quality of life. Changes of intestinal microbiota and intestinal permeability were also analyzed. Results and Discussion. Weekly AR was not different among the 4 groups throughout the treatment period. However, the 3 treatment groups exhibited significant improvements in PR compared to the findings in the placebo group. In the intestinal microbiota assessment, herbal medicine and probiotics synergistically increased beneficial bacteria counts. Conclusion. Combination therapy with herbal medicine and probiotics appears to relieve overall IBS symptoms by synergistically increasing beneficial intestinal microbe counts

Compositional assessment of carotenoid-biofortified rice using substantial equivalence

One important aspect in assessing the safety of genetically modified (GM) crops for human consumption is characterizing their nutrient composition. A β-carotene-biofortified rice was generated by inserting phytoene synthase (Psy) and carotene desaturase (Crtl) genes isolated from Capsicum and Pantoea into the genome of a conventional variety of rice (Nakdongbyeo). Nutrients (proximates, amino acids, fatty acids, minerals, and vitamins), anti-nutritive components (trypsin inhibitors and phytic acid), and ferulic acid in GM rice were compared with those in the parent line Nakdongbyeo. Statistical comparisons to test for equivalence showed that all of the analyzed components in the GM plants were equivalent to those in its non-transgenic counterpart, and most nutritional components fell within the range of values reported for other commercial lines, indicating the safety of the GM plant.Key words: Genetically modified crop, β-Carotene, Transgenic rice, Nutrient, Substantial equivalence

Reliability and Validity of Modified Algometer in Abdominal Examination

Objective. Abdominal examination (AE) is one of the essential diagnostic methods in traditional Korean medicine that has been widely used for deciding treatment, cause, and prognosis of the disease. AE majorly depends on the experience of practitioners; therefore, standardization and quantification of AE are desperately needed. However, few studies have tried to objectify AE and established its standard. We assessed the reliability and validity of newly developed diagnostic device for AE called modified algometer (MA). Methods. Thirty-six subjects with functional dyspepsia were allocated into one of 2 groups according to gold standard of AE: epigastric discomfort without tenderness (n=23) group or epigastric discomfort with tenderness (n=13) group. Pressure pain threshold was evaluated at participants’ epigastric region with algometer and MA. We assessed reliability and validity (sensitivity and specificity) and calculated optimal cutoff value. Results. MA showed high intertrial reliability (ICC 0.849; 0.703–0.923; P<0.000) and validity (sensitivity: 76.92%; specificity: 60.87%), and cutoff value was 330.0 mmHg. Algometer and MA showed moderate correlation (r=0.583, P≤0.000). Conclusion. MA can be reliable and valid diagnostic device for AE and has the possibility of practical use for quantification and standardization of AE