血必净注射液治疗重度腹腔感染有效性的Meta分析OA

Objective This Meta-analysis aimed to quantitatively assess the therapeutic efficacy of Xuebijing injection in patients with severe intra-abdominal infection.Methods We systematically searched eight electronic databases from database establishment to October 22,2024 for eligible randomized controlled trial(RCT)investigating Xuebijing injection in severe intra-abdominal infection.The databases included China National Knowledge Infrastructure(CNKI),Wanfang Data,Chinese Biomedical Literature Database(CBM),VIP Database,PubMed,Embase,Web of Science and the Cochrane Library.The control group received conventional Western medicine treatment,while the experimental group received a combination of Xuebijing injection and conventional Western medicine treatment.Two researchers independently screened literature and collected information and evaluated the quality of the included literature.Data synthesis and Meta-analysis were performed using RevMan 5.4 and Stata 18.0 to evaluate the effects of Xuebijing injection on patients with severe abdominal infection.The outcomes assessed included endotoxin,interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),procalcitonin(PCT),CD4+T-cell count,CD4+/CD8+ratio,time to intestinal function recovery,length of hospital stay,gastrointestinal function score,and acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score.Funnel plots were generated to assess publication bias for the outcome,which was included in eight or more studies.Results A total of 14 studies were ultimately included in the Meta-analysis.Based on the quality assessment,2 studies scored≥4 and 12 studies scored<4.Overall,1 155 patients were enrolled,with 578 patients in the experimental group and 577 patients in the control group.Meta-analysis results demonstrated that,compared with the control group,the addition of Xuebijing injection to conventional treatment in the experimental group significantly reduced endotoxin[mean difference(MD)=-10.78,95％confidence interval(95％CI)was-14.30 to-7.27,P<0.05],IL-6(MD=-13.07,95％CI was-21.90 to-4.28,P<0.05),TNF-α(MD=-6.99,95％CI was-9.51 to-4.46,P<0.05),and PCT(MD=-0.61,95％CI was-0.94 to-0.28,P<0.05)levels,increased CD4+T-cell count(MD=6.75,95％CI was 4.23-9.27,P<0.05)and CD4+/CD8+ratio(MD=0.35,95％CI was 0.30-0.41,P<0.05),shortened time to intestinal function recovery(MD=-1.31,95％CI was-1.67 to-0.95,P<0.05)and length of hospital stay(MD=-4.11,95％CI was-7.00 to-1.23,P<0.05),as well as reduced gastrointestinal function score(MD=-0.34,95％CI was-0.49 to-0.19,P<0.05)and APACHE Ⅱ score(MD=-2.79,95％CI was-3.27 to-2.30,P<0.05).Conclusions Xuebijing injection can alleviate inflammation in patients with severe intra-abdominal infection,enhance immune function,and improve gastrointestinal function and prognosis.However,due to research limitations,more high-quality studies are needed in the future to verify its efficacy and safety.