Epidermal growth factor receptor modulation for neural repair: Implications for neurodegenerative disease therapy.

Functional dyspepsia (FD) is a chronic gastrointestinal disorder characterized by symptoms such as postprandial fullness, early satiation, epigastric pain, or epigastric burning. According to the Rome IV criteria, FD is diagnosed when these symptoms occur in the absence of any identifiable structural or organic disease that could explain them, provided that the symptoms begin at least 6 months prior to diagnosis and have been present during the preceding 3 months []. A recent large-scale systematic review and meta-analysis estimated the global prevalence of FD to be approximately 7.2% based on the Rome IV criteria []. In South Korea, dyspepsia ranked seventh among outpatient conditions in Korean Medicine (KM) clinics according to the 2024 Health Insurance Statistics Yearbook and has consistently remained within the top 10 over the past decade []. This sustained high ranking reflects the substantial and ongoing demand for KM treatment and highlights its contribution to the overall healthcare burden in South Korea. The underlying mechanisms of FD are complex and heterogeneous. The key physiological drivers include gastric dysmotility (e.g., delayed emptying and compromised fundic accommodation), heightened visceral sensitivity, alterations in duodenal mucosal integrity, disturbances in the gut microbiome, and various psychological factors []. Given the multifactorial nature of FD, conventional therapies such as proton pump inhibitors (PPIs) and prokinetics often yield suboptimal outcomes, as they typically target only a single mechanism rather than the full spectrum of the disorder []. Moreover, the extended administration of pharmacological agents such as PPIs and prokinetics is frequently restricted by concerns about adverse effects, including cardiovascular and metabolic risks [,]. Consequently, many patients seek alternative treatment options, resulting in an increased demand for KM treatment. In KM, FD is managed through individualized interventions, with herbal decoctions (HDs) serving as the core modality. Although various herbal medicines (HMs) have demonstrated clinical efficacy against FD in randomized controlled trials (RCTs) [,], these explanatory studies often have inherent limitations in their clinical applicability. Most existing RCTs have been conducted in highly controlled hospital-based settings with rigid inclusion criteria that do not fully account for the complexity of primary care. Specifically, the standardized protocols of traditional RCTs often overlook the individualized nature of KM, in which treatments are dynamically adjusted based on pattern identification () and patient-centered factors []. Alternative designs such as pragmatic trials or cluster-randomized trials can provide comparative real-world evidence; however, they may still have limitations in fully reflecting the flexible, individualized nature of primary KM practice.