Efficacy of Banha-sasim-tang in Patients with Functional Dyspepsia: A Network Meta-analysis

Objectives: To compare the relative efficacy of Banha-sasim-tang (BXT) with commonly used gastrointestinal motilitymodifying agents in adult patients with functional dyspepsia using a network meta-analysis.Methods: A systematic review and frequentist network meta-analysis were conducted according to the PRISMA 2020 guideline. Randomized controlled trials comparing oral BXT monotherapy with placebo, mosapride, domperidone, or trimebutine malate in adults with functional dyspepsia were included. The primary outcome was total clinical efficacy (TCE), and the secondary outcome was post-treatment dyspepsia-symptom scores. Risk ratios (RRs) were calculated for primary outcome, and standardized mean differences (SMDs) were calculated for secondary outcome. A random-effects model was applied, and treatment ranking was estimated using P-scores.Results: 11 randomized controlled trials were included. In the network meta-analysis for TCE, BXT showed a significant benefit over placebo (RR 1.67, 95% CI 1.27 to 2.19). Domperidone (RR 1.43, 95% CI 1.09 to 1.86) and mosapride (RR 1.61, 95% CI 1.22 to 2.12) were also significantly superior to placebo, whereas trimebutine malate was not. For post-treatment dyspepsia-symptom scores, BXT ranked highest, but no treatment showed a statistically significant difference versus placebo.Conclusions: BXT may be an effective treatment option for functional dyspepsia, showing favorable efficacy in overall clinical response. Further well-designed randomized controlled trials with standardized outcome measures and direct head-to-head comparisons are needed to better define its clinical role in the management of functional dyspepsia.