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

Abstract

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.