ABSTRACT
<p><b>OBJECTIVES</b>To evaluate the efficacy and safety of Chinese herbal medicine Xingnaojing Injection () for newborns with hypoxic ischemic encephalopathy (HIE).</p><p><b>METHODS</b>Literatures were identified by searching the PubMed, EMBASE, Cochrane Library, Cochrane Central, and four Chinese literature databases from the establishment of database to October in 2013. Relevant reference lists were also screened. Two reviewers independently evaluated the methodological quality of included studies. We also conducted the meta-analysis.</p><p><b>RESULTS</b>Thirteen trials involving 1,169 patients were included. There was no trial reported death or disability at the end of follow-up period. Meta-analysis of 4 trials (n=371) showed that there was no significant difference in the reduction of mortality [risk ratios (RR)=0.48, 95% confidence intervals (CI, 0.21, 1.13), P=0.09] between the Xingnaojing and control groups. Meta-analysis of 5 trials (n=359) showed that there was significant difference in reducing the major neurodevelopmental disability [RR=0.36, 95% CI (0.19, 0.66), P=0.001]. Meta-analysis of 6 trials (n=447) showed that there was significant difference in the author self-defined symptom improvement [RR=1.25, 95% CI (1.14, 1.37), P<0.01]. No fatal side-effects were reported.</p><p><b>CONCLUSION</b>Based on the limited evidence, the routine use of Xingnaojing Injection for treatment of HIE in newborns is not recommended. Further well-conducted trials are justified.</p>
ABSTRACT
Objective To evaluate the efficacy and safety of Radix Astragali(Huang Qi) for newborns with hypoxic ischemic encephalopathy(HIE). Methods We searched the Cochrane library, PubMed, Cochrane, EMBASE, CBM, CNKI, VIP and Wanfang database, randomized controlled trial(RCT) evaluating the efficacy and safety of Huang Qi for newborns with HIE would be included and the methodological quality of RCT was evaluated according to the Cochrane Handbook for Systematic Reviews of Interventions version 5.1.0. Results Thirteen studies were included (1031 patients), 11 RCT used open control as control, 2 RCT used positive control. There was no trial reported the death or disability at the end of 12 months follow-up period. Meta-analysis of one study showed Huang Qi group could not significantly reduced mortality rate of HIE compared with open control group (RR=0.33, 95%CI (0.04, 3.07)). Meta analysis of 7 studies (n=597) showed that the efficacy rate of huang Qi group was significantly higher than that of open control group in treatment of HIE (RR=1.22, 95%CI (1.07, 1.39), I2=48%). Meta-analysis of 3 trials (n=163) showed that there was significant difference in the improvement of NANA scale on the seventh day (MD=5.37, 95%CI (1.46, 9.27), I2=89%) between Huang Qi group and open control group. Meta-analysis of 2 trials (n=111) showed that there was significant difference in the improvement of NANA scale on the tenth day (MD=2.03, 95%CI (1.37, 2.69), I2=0) between Huang Qi group and open control group. No fatal side effects were reported. Conclusion Based on the current evidence, due to the limitation of quality of included studies and sample size, the routine use of Huang Qi for treatment of HIE in newborns is not recommended. The long-term efficacy and safety studies are required to confirm it.
ABSTRACT
OBJECTIVE: To understand the patient' satisfaction with one-to-one pre-dispensing mode in outpatient pharmacy and the status of dispensing mode in mainland China, promoting to improve the quality of outpatient pharmacy services. METHODS: A questionnaire regarding patients' satisfaction with dispensing mode was undertaken. Meanwhile, researches evaluating dispensing mode were identified from CBM, CNKI, VIPdatabase, systematic review was conducted to analyze this included studies. RESULTS: A total of 216 questionnaires were finished in outpatient pharmacy, 191 (88.4%) were valid questionnaires, 89% of patients got medicine in 5 min, 95.9% thought the medication label message was clear, 97.9% of the patients were satisfied with the dispensing mode and 95.8% with the overall quality of service. The systematic review included 25 studies, 92% of studies were before and after control study, 4% were randomized controlled study, 4% were survey; 52% evaluated before and after counter dispensing mode, 20% evaluated automatic dispensing system, 12% evaluate done card dispensing mode, 4% evaluated barcode scanning dispensing system; 48% of the studies used dispensing error events as outcome measurement, 44% used waiting time for medication, 24% used patient' satisfaction; before and after counter dispensing mode was the most common dispensing mode; one card dispensing mode optimized the dispensing process, it was widely used in economically developed regions and numerous patients in outpatient; automated dispensing model only applied in some hospitals due to higher costs and space requirement. CONCLUSION: Overall, patients were satisfied with one-to-one pre-dispensing mode in outpatient pharmacy, one card dispensing mode was worth learning in the process of optimizing the quality of outpatient service in future. At present, there were several dispensing mode, without a unified outcome measurement, further studies are needed to confirm it.