ABSTRACT
In this study, an overview of systematic reviews/Meta-analysis(SR/MA) of Chinese herbal injections for sepsis was performed to provide references for clinical practice and promote the quality improvement of clinical evidence. Eight Chinese and English databases such as CNKI, Medline, and EMbase were electronically searched for SR/MA of Chinese herbal injections for sepsis from database inception to June 2022. AMSTAR 2, PRISMA 2020, and GRADE system, combined with Recommendations for Clinical Evidence Grading on Traditional Chinese Medicine Based on Evidence Body, were applied to evaluate the methodological quality, reporting quality, and evidence quality of the included articles. Twenty-seven articles of SR/MA were included, containing four Chinese herbal injections(Xuebijing Injection, Shenfu Injection, Shenmai Injection, and Shengmai Injection). AMSTAR 2 checklist showed that the methodological quality of the SR/MA ranged from moderate to very low. Item 2(prior study design) was the critical item with poor scores, and the non-critical items with poor scores were items 3(explain the selection of the study designs), items 10(report on the sources of funding), and items 16(conflicts of interest stated). In terms of PRISMA 2020, items in eight topics with complete reporting of missing>50%, including search strategy, certainty assessment, results of syntheses, certainty of evidence, registration and protocol, support, competing interests, availability of data, code and other materials. The included SR/MA involved 30 outcome indicators. Evidence quality of mortality, APACHE Ⅱ, and safety, the top three outcome indicators, was evaluated, and all of them were graded as the medium level. The lack of random allocation sequence, allocation concealment mechanism, blinding, and trial sample size was the main reason for the reduction of the evidence level. The available evidence shows that Chinese herbal injections can serve as an effective and safe adjunctive treatment for sepsis, which can reduce mortality, inhibit inflammation, improve coagulation function, and regulate immune function, tissue perfusion, and oxygenation in patients with sepsis. However, the quality of SR/MA was suboptimal, and more high-quality SR/MA is needed to provide evidence to support the efficacy and safety of Chinese herbal injections in the treatment of sepsis.
Subject(s)
Humans , Injections , Medicine, Chinese Traditional , Research Design , Sepsis/drug therapyABSTRACT
The present study evaluated the curative efficacy of Chinese herbal injection on unstable angina pectoris( UAP) by network Meta-analysis. The databases,including Pub Med,Cochrane Library,Web of Science,CNKI,CBM,VIP and Wanfang were searched for randomized controlled trial( RCT) of Chinese herbal injection in the treatment of UAP. All researchers independently screened the articles,extracted the data and evaluated the quality. Open BUGS and Stata were employed for the analysis of the trials that met the quality standards. Fifty-eight studies were finally included in this study,involving 20 intervention measures. In terms of the effective rate,16 injections such as Dengzhan Xixin Injection,Xuesaitong Injection and Danshen Injection combined with western medicine exhibited significant efficacy. In terms of ECG,Puerarin Injection,Ginkgo Leaf Extract and Dipyridamole Injection( GDI),Breviscapine Injection combined with western medicine were superior to western medicine. In terms of the reduction of the angina attack times,Sodium Tanshinone ⅡASulfonate Injection,GDI and Dazhu Hongjingtian Injection combined with western medicine showed better effects than western medicine. In terms of shortening the angina duration,Shenmai Injection combined with western medicine was superior to western medicine. As revealed by the results,Dengzhan Xixin Injection,Xuesaitong Injection,Danshen Injection,Breviscapine Injection,Danshen Ligustrazine Injection combined with western medicine displayed prominent curative efficacy,which were recommended for clinical application. Meanwhile,appropriate intervention measures should be selected according to individual conditions. Limited by the quality of the included trials,the conclusions still need to be further verified.
Subject(s)
Humans , Angina Pectoris , Angina, Unstable/drug therapy , China , Drugs, Chinese Herbal , Network Meta-Analysis , Treatment OutcomeABSTRACT
Objective To investigate the epidemiological characteristics of adverse drug reactions (ADRs) induced by Chinese herbal injection for tonify, and provide reference for safety evaluation and rational use. Methods The ADR cases that issued on the domestic medicinal periodicals from 1972 to 2011 in China were collected comprehensively to build a database, and analyzed by statistic methods. Results Totally 233 ADR cases involving 7 different kinds of Chinese herbal injection for tonify were collected, in which 86 cases weighted the most were related to Huangqi Injection. Chinese herbal injection for tonify may induce multiple systematic ADRs. The incidence of respiratory damage was 27.0%(80 cases), which was dominated in the ADRs. The incidence of ADRs had no difference between the genders (male was 117 cases, 50.2%, and female was 116 cases, 49.8%), and the average age of patients was (51.40±16.67) years old. ADRs often occurred within half an hour after the start of infusion (64.5%). The diseases of patients mostly were cancer (19.3%), coronary heart disease (15.9%), and hypertension (6.0%), etc. Only 76 cases mentioned the combination therapy, which mainly combined with the drugs of antibiotics, other traditional Chinese medicines and vitamin. Conclusion ADRs of Chinese herbal injection for tonify are always induced by drug combinations, inappropriate medication, and other factors. To use Chinese herbal injection more rational and enhance prevention awareness may be the key to reduce the occurrence of ADRs.
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Objective: To investigate the current situation of consumption and development tendency of antitumor Chinese herbal injections in Wuhan area. Methods:The analytical method of the defined daily dose ( DDD) recommended by WHO was used to ana-lyze the application of antitumor Chinese herbal injections in 32 hospitals of Wuhan area during the period of 2010-2012. Results:The consumption sum and the DDDs of antitumor Chinese herbal injections were increased year after year, while the daily drug cost ( DDC) was stable in general. The sort of consumption was generally in accordance with the sequence of DDDs. Conclusion:The status quo of antitumor Chinese herbal injections during the period of 2010-2012 is in line with the characteristics of clinical application, indicating the use is rational.
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Objective To investigate the epidemiological characteristics of adverse reaction induced by Chinese herbal injection. Methods Multiple cases report in domestic medical periodicals were searched and analysed by bibliometric and statistic meth-ods. Results Fifty-six reports on muti-ADR cases related to 16 different kinds of Chinese herbal injection were collected. There were 67299 patients and 1348 ADR cases related to Chinese herbal injection. The average ADR incidence was 2.00 % ;the highest incidence of 43.28 % was shown in cinobufotalin injection and the lowest incidence of 0. 25 % in zedoary turmeric oil injection). Skin lesion, and circulatory and digestive lesion dominated in ADRs. Conclusion we should use Chinese herbal in-jection more rationally, and enhance prevention awareness to reduce the incidence of ADR induced by Chinese herbal injection.