Yukgunja-tang and Pyeongwi-san improve functional dyspepsia and modulate ghrelin dynamics: A multicenter randomized controlled trial.
Boram Lee, Na-Yeon Ha, O-Jin Kwon et al.
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In 30 seconds
This multicenter, assessor-blind randomized controlled trial compared Yukgunja-tang (YGJ) and Pyeongwi-san (PWS) with usual care (UC) in 140 patients with functional dyspepsia treated for 6 weeks. Both herbal formulations reduced Total Dyspepsia Symptom Scale scores more than UC at week 6: the mean difference was -1.63 (95% CI, -2.94 to -0.31) for YGJ and -1.55 (95% CI, -2.98 to -0.12) for PWS. No significant difference was found between the herbal groups. Compliance exceeded 92%, and no serious treatment-related adverse events were reported.
Key findings
- At week 6, TDS scores favored YGJ over UC (MD -1.63; 95% CI, -2.94 to -0.31) and PWS over UC (MD -1.55; 95% CI, -2.98 to -0.12).
- No significant overall efficacy difference was observed between YGJ and PWS; YGJ showed more consistent symptom improvements and improved depressive symptoms and spleen qi deficiency-related outcomes.
- Both groups had exploratory within-group reductions in des-acyl ghrelin; PWS also increased the acyl-ghrelin ratio.
- Drug compliance exceeded 92%, with no serious treatment-related adverse events.
Why it matters
The trial provides comparative randomized evidence that both formulations may reduce dyspeptic symptoms beyond usual care, while suggesting potentially different symptom, psychological, and ghrelin-related response patterns. The ghrelin findings are exploratory and do not establish a mechanism. Because the comparator was usual care rather than placebo, the results should be interpreted cautiously when considering the magnitude of benefit.
What to keep in mind
Usual care, rather than placebo, was the comparator, limiting interpretation of the treatment-specific effect. Ghrelin changes were exploratory and reported as within-group findings.