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Residual dizziness is a common and troublesome complaint that persists in many patients following canalith repositioning procedures for benign paroxysmal positional vertigo. Spleen-strengthening and phlegm-resolving herbal therapy is a classical traditional Chinese medicine approach that targets the underlying pattern of spleen deficiency and phlegm accumulation believed to contribute to this condition. This systematic review and meta-analysis pooled evidence from thirty-seven randomised controlled trials involving 2,794 participants to assess whether this herbal approach offers meaningful clinical benefit.
The analysis found that spleen-strengthening and phlegm-resolving therapy, whether used alone or alongside standard medical care, significantly reduced dizziness handicap inventory scores, visual analogue scale pain and symptom scores, and traditional Chinese medicine syndrome scores compared with standard care alone. Patients receiving the herbal therapy also achieved higher rates of dizziness resolution and overall clinical improvement. When combined with standard care, the therapy additionally appeared to lower the rate of dizziness recurrence. No severe adverse events were reported among the studies that documented safety outcomes; however, adverse event reporting was inconsistent across the included trials, leaving the full safety profile uncertain.
The authors acknowledge that the methodological quality of included studies was variable and that larger, rigorously designed randomised controlled trials are needed to confirm these findings.
Conclusion: Spleen-strengthening and phlegm-resolving herbal therapy appears to meaningfully reduce residual dizziness symptoms and may lower recurrence rates, but incomplete safety reporting means its full risk profile remains to be established.
Source: Zhang Y, Sun Y, Li Q and colleagues. Frontiers in medicine (2026). View on PubMed (PMID 42973526) · doi:10.3389/fmed.2026.1949948