Adjunctive Anweiyang capsules combined with Western medicine for peptic ulcer disease: a systematic review and meta-analysis of randomized controlled trials

Abstract

Introduction Anweiyang capsules, a Chinese patent medicine, are used to reinforce qi, resolve toxic substances, and promote healing. In this study, we aimed to conduct the first meta-analysis comprehensively evaluating the clinical effectiveness and safety of Anweiyang capsules combined with Western medicine for the treatment of peptic ulcer disease (PUD). Methods Eight databases were systematically searched up to July 2025 and the further updated to May 1, 2026. The Cochrane risk of bias (ROB) 2.0 tool was used to assess the risk of bias in the included randomized controlled trials (RCTs), and evidence quality was evaluated using the GRADE tool. Results Thirty-six RCTs involving 3858 patients were included. In subgroup meta-analyses based on the background Western medicine regimen, the addition of Anweiyang capsules was associated with a higher clinical effectiveness rate compared with Western medicine alone (standard quadruple therapy: risk ratio [RR] = 1.19, 95% confidence interval [CI]: 1.13, 1.24; standard triple therapy: RR = 1.11, 95% CI: 1.06, 1.16; other regimens: RR = 1.20, 95% CI: 1.16, 1.25). Similar associations were observed for Helicobacter pylori eradication (quadruple: RR = 1.24, 95% CI: 1.17, 1.31; triple: RR = 1.16, 95% CI: 1.10, 1.23; and other: RR = 1.20, 95% CI: 1.13, 1.27). Owing to heterogeneity, gastrointestinal hormones, cytokines, and angiogenic markers were analyzed descriptively, demonstrating reductions in gastrin, motilin, and interleukin-6, along with increased vascular endothelial growth factor levels. Traditional Chinese medicine treatment was also associated with reductions in epigastric pain scores and peptic ulcer recurrence rates. No significant differences in adverse events were observed between the groups. However, most studies showed “some concerns” regarding risk of bias based on ROB 2.0 and low GRADE evidence quality. Conclusion Although this study suggests Anweiyang capsules combined with Western medicine is effective and safe for PUD, further high-quality, large-scale RCTs are warranted for confirmation.

Keywords

Anweiyang capsule / peptic ulcer disease / meta-analysis / systematic review / clinical effectiveness

Electronic Supplementary Material

The online version contains supplementary material available at https://doi.org/10.26599/eCMTA.2026.9570034.

Funding

This work was supported by the Comprehensive Evaluation Study of Anweiyang capsules (grant no.: HXGSHT-BZYSY-2022-023).

Author Contribution Statement

Hong-san Zhang: Data curation, methodology, software, formal analysis, visualization, and writing - original draft. Zhi-jun Bu: Data curation, formal analysis, methodology, visualization, and writing - review & editing. Yuan Sun: Methodology, software, and writing - review & editing. Shi-yu Tian: Methodology, visualization, and writing - review & editing. Yuan-hang Zhao: Formal analysis and writing - review & editing. Kang Han: Investigation and writing - review & editing. Zhao-lan Liu: Supervision and writing- review & editing. Hui-lan Liu: Conceptualization, formal analysis, data curation, funding acquisition, methodology, project administration, supervision, and writing - review & editing.

Declaration of Competing Interest

This study was supported by the Comprehensive Evaluation Study of Anweiyang capsules (grant no.: HXGSHT-BZYSY-2022-023), which was funded by Xinjiang Quan’an Pharmaceutical Co., Ltd. The funder had no role in the study design, data collection, data analysis, data interpretation, or manuscript preparation. No employee, officer, or board member of the funding company served as an author or contributed to any part of this review. None of the authors is an employee, consultant, or stockholder of the funder.

Given the financial support from the manufacturer of the product under evaluation, the authors acknowledge the potential for non-financial conflict of interest regarding the interpretation of the results. To minimize bias, we adhered to a pre-registered protocol (PROSPERO: CRD420251087273), performed independent duplicate study selection and data extraction, and conducted sensitivity analyses, excluding any primary study directly funded by the manufacturer. All conclusions were based solely on the available evidence, and the final decision to submit the manuscript was made independently by the authors without any influence from the funder.

Data Availability

Additional data related to this paper may be obtained from the corresponding author upon reasonable request.

Use of an AI statement

None.

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