scholarly journals Efficacy of Xuebijing Injection for Acute Pancreatitis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 2021 ◽  
pp. 1-14
Author(s):  
Hongxin Chen ◽  
Zhaohui Bai ◽  
Hongyu Li ◽  
Yanyan Wu ◽  
Haijuan Yao ◽  
...  

Background and Aim. Xuebijing injection is a traditional Chinese medicine compound for the improvement of systemic inflammation response. This meta-analysis of randomized controlled trials (RCTs) aimed to explore the clinical efficacy and safety of Xuebijing injection for the treatment of acute pancreatitis (AP). Methods. PubMed Medline, Embase, Cochrane Library, China National Knowledge Infrastructure, China Biology Medicine disc, VIP, and Wanfang databases were searched. The primary outcome was treatment response. The secondary outcomes included changes in clinical and laboratory indicators and incidence of AP-related complications. Meta-analyses were performed by using a random-effect model. Risk ratios (RRs) with 95% confidence intervals (CIs) or weighted mean differences (WMDs) with 95% CIs were calculated. Results. Overall, 23 RCTs were included. The rates of overall (RR = 1.16; 95% CI = 1.12 to 1.20; P < 0.00001 ) and complete (RR = 1.40; 95% CI = 1.30 to 1.50; P < 0.00001 ) responses were significantly higher in the Xuebijing injection group. After treatment, the levels of interleukin-6 (WMD = −18.22; 95% CI = −23.36 to −13.08; P < 0.00001 ), tumor necrosis factor-α (WMD = −16.44; 95% CI = −20.49 to −12.40; P < 0.00001 ), serum amylase (WMD = −105.61; 95% CI = −173.77 to −37.46; P = 0.002 ), white blood cell (WMD = −1.51; 95% CI = −1.66 to −1.36; P < 0.00001 ), and C-reactive protein (WMD = −11.05; 95% CI = −14.32 to −7.78; P < 0.00001 ) were significantly lower in the Xuebijing injection group. Abdominal pain (WMD = −1.74; 95% CI = −1.96 to −1.52; P < 0.00001 ), abdominal distension (WMD = −1.56; 95% CI = −2.07 to −1.04; P < 0.00001 ), gastrointestinal function (WMD = −2.60; 95% CI = −3.07 to −2.13; P < 0.00001 ), body temperature (WMD = −2.16; 95% CI = −2.83 to −1.49; P < 0.00001 ), serum amylase level (WMD = −1.81; 95% CI = −2.66 to −0.96; P < 0.0001 ), and white blood cell (WMD = −2.16; 95% CI = −2.99 to −1.32; P < 0.00001 ) recovered more rapidly in the Xuebijing injection group. The incidence of multiple organ dysfunction syndrome (RR = 0.18; 95% CI = 0.05 to 0.62; P = 0.006 ), pancreatic pseudocyst (RR = 0.17; 95% CI = 0.04 to 0.77; P = 0.02 ), and renal failure (RR = 0.16; 95% CI = 0.05 to 0.60; P = 0.006 ) was significantly lower in the Xuebijing injection group. Conclusions. Xuebijing injection added on the basis of conventional treatment has a potential benefit for improving the outcomes of AP.

Author(s):  
sijia Ma ◽  
mingming Zhao ◽  
zhiyu Pan ◽  
jiao Fan ◽  
xuexue Zhang ◽  
...  

Abstract:Objective: The purpose of this study was to investigate the effect of continuous renal replacement therapy(CRRT) on patients with acute pancreatitis(AP). Methods: A comprehensive search of seven databases without language restrictions includes PubMed, Cochrane Library, Scopus, Embase, Web of Science, China National Knowledge Infrastructure(CNKI) and Wan fang database. Randomized controlled trials (RCTs) for the treatment of acute pancreatitis with CRRT were searched. All the included literatures were published before December 2020. Two review authors independently selected the study and extracted the data according to the inclusion criteria. A third review author will and discuss with the first two review authors and resolve the differences. Weighted mean difference(WMD), risk ratio (RR), and 95% confidence interval (CI) were used for estimating the clinical efficacy of AP in CRRT and control treatment. Results: Fifty-three RCTs met the inclusion criteria and were used in the meta-analysis, with a total of 3,382 effective samples. A comprehensive review of the system shows that the mortality rate of the CRRT group was significantly lower than that of the control group, and the difference was statistically significant(RR=0.44,95%CI0.34 to 0.57,P< 0.000001), the patients using CRRT had lower APACHE Ⅱ scores level(WMD=-3.78, 95%CI-4.66 to -2.90,P<0.00001),higher CRP, PCT,TNF-αand IL-6 clearance effect. According to liver function, the patients using CRRT had lower ALT and AST levels. In the same way, according to renal function, the patients using CRRT had lower SCr (WMD=-94.28, 95%CI-125.47 to -63.10, P<0.00001). The patients using CRRT also had higher ALB levels(WMD=2.32, 95%CI-1.05 to 3.59 ,P=0.0003). Moreover, Results shown no statistical difference in Serum potassium level (WMD=-0.00, 95%CI-0.31 to 0.31,P=1.00)between the two groups. Conclusions: Our findings suggest that treatment with CRRT for acute pancreatitis may be more beneficial than conventional treatment. However, high-quality studies with a larger sample size are still needed to confirm our results.


Pancreatology ◽  
2013 ◽  
Vol 13 (5) ◽  
pp. 468-474 ◽  
Author(s):  
Varsha Asrani ◽  
Wai Keat Chang ◽  
Zhiyong Dong ◽  
Gil Hardy ◽  
John A. Windsor ◽  
...  

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