Clinical Curative Effect Of Xuebijing For Acute Respiratory Distress Syndrome:A Meta-analysis

Objective:To systematically evaluate the clinical curative effect of Xuebijing for acute respiratory distress syndrome(ARDS) so as to provide the reference basis for clinical strategies.Methods:The datas that randomized controlled trials (RCTs) and controlled clinical trials on the effect of Xuebijing for ADRS were collected through retrieving the Chinese Biological and Medical Database (CBM), China National Knowledge Infrastructure (CNKI), Wanfang Data Platform, VIP Data Platform (VIP), Pubmed, Ovid, Embase and Cochrane library via computer system as well as manually retrieving the unpublished negative literature and investigating the references until December 31,2015. Data filtering, quality evaluation and effective data extraction were performed independently by two reviewers for the eligible literatures and studies using the systemic evaluation method provided by Cochrane Collaboration. Discussion or third-party judgment would be performed in cases of disagreement between the two reviewers. Finally, the forest plots and sensitivity analysis graph were developed by RevMan 5.3 software and Stata 12 software, whereas funnel plots were applied to present publication bias.Results: ?A total of 15 papers involved 947 cases of ARDS patients, including 564 males that accounted for 60% of the total number and 383 females that accounted for 40%, suggesting a male-female incidence rate of about 1.5:1.The quality of incorporated studies was normal and indicated a moderate bias risk.?Meta-analysis results showed that compared with the control group in terms of prognosis, the Xuebijing group could reducethe mortality rate of ARDS patients [RR=0.56,95%CI=(0.45,0.70) P?0.00001]and improve the effective rate of clinical treatment[RR=1.60,95%CI=(1.30,1.96); P?0.0001]; lower ARDS patient APACHE ? scores [WMD=-2.43,95%CI=(-3.55,-1.30); P?0.0001] and the lung injury scores [WMD=-0.25,95%CI=(-0.34,-0.17); P<0.00001]; and enhanced patient oxygenation index [WMD=43.28,95%CI=(38.90,47.67); P<0.00001].In terms of downregulation of inflammatory mediators, the Xuebijing group was associated with reduced serum C-reactive protein levels [SMD=-1.08,95%CI=(-1.54,-0.63);P?0.00001], serum TNF-a levels[SMD=-1.12,95%CI=(-1.53,-0.71);P?0.00001] and Interleukin-6 levels [SMD=-0.96,95%CI=(-1.19,-0.72);P?0.00001]compared with the control group. There was indicated low possibility of publication bias by funnel-plot. ?There were no adverse reactions during treatment in only 3 study reports, while all the rest of studies didn't report anything about whether there are adverse reactions or not Because of the unsound results about mechanical ventilation duration from the papers,their relative information was not combined for analysis.Conclusion:The results show that Xuebijing can improve the prognosis and oxygenation index of ARDS patients, downregulate the level of inflammatory mediators and alleviate systemic inflammatory responses.However, considering the limitations of this study, more scrupulously designed high-quality, large-scale and multi-center clinical randomized controlled trials are required to further verify the results.