Evidence Explorer · MS-N230 · Korean/Japanese traditional multi-herb medicine · Supportive care · Appraised November 4, 2026
A two-week open-label pilot found better insomnia scores with Gamiguibi-tang than with a wait-list. The comparison does not separate a pharmacologic effect from attention, expectancy or natural fluctuation.
Evidence at a glance
Benefit signal: Preliminary improvement in insomnia severity
Certainty: Very low; 30-person open-label wait-list trial and one product-specific formulation
Risk context: Mild dyspepsia and edema occurred; multi-herb interaction and quality risks remain
What was studied
Thirty adults with gastrointestinal, breast or lung cancers and poor sleep were randomized to Gamiguibi-tang plus usual care or a wait-list for two weeks. The spray-dried product contained extracts of 14 plants, including Astragalus, Bupleurum, ginseng, licorice, ginger and Japanese Angelica.
Insomnia Severity Index scores changed by −5.5 ± 4.4 with the formula versus 0.1 ± 1.1 with wait-list care (P<.001). Brief Fatigue Inventory change was −0.8 versus 0.0, while depression and cognitive scores did not differ.
What this evidence cannot establish
The trial was not blinded and used no matched placebo or attention control. Two weeks is too short to establish durable benefit or uncommon harm.
A 2026 systematic review rated the evidence for each reviewed herbal preparation very low certainty. Results cannot be generalized to products with different species, ratios or manufacturing.
Practical safety context
Mild dyspepsia and edema were reported. Licorice-containing formulas may affect potassium, blood pressure and drug metabolism; other ingredients can add bleeding, sedation or immune effects.
Persistent insomnia should prompt assessment for pain, corticosteroids, depression, sleep apnea, hot flashes and treatment-related endocrine problems.
Questions for the care team
- Is the proposed product the same 14-herb formulation and dose used in the trial?
- Could licorice, ginseng, Angelica or other components interact with treatment?
- Would CBT-I or another evidence-based sleep intervention be more appropriate?
- How will edema, blood pressure, potassium and sleep response be monitored?
Funding and conflicts
The primary report lists non-U.S. government research support. Detailed manufacturer involvement was not verified; the small trial was not powered for safety.
Sources
- Pilot randomized trial (PMID 29034740)
- 2026 systematic review of oral herbal preparations in supportive cancer care (PMID 42930516)
Sources and publication status checked November 4, 2026. Last literature search: November 4, 2026; record appraisal: November 4, 2026.
For education, not personal medical advice. Research regimens are not personal prescriptions. Symptom, laboratory or biomarker changes do not establish tumor response, recurrence prevention or longer survival.
