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

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).

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.

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.

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.

The study protocol was registered with the International Prospective Register of Systematic Reviews (https://www.crd.york.ac.uk/PROSPERO/, CRD420251087273).