Could Xuebijing Injection Reduce the Mortality of Severe Pneumonia Patients? A Systematic Review and Meta-Analysis

Background and Aim. Xuebijing injection (XBJ) is a Chinese traditional medicine preparation, mainly made from Carthamus tinctorius flowers (Honghua in Chinese), Paeonia lactiflora roots (Chishao), Ligusticum chuanxiong rhizomes (Chuanxiong), Salvia miltiorrhiza roots (Danshen), and Angelica sinensis roots (Danggui). It can reduce inflammation and regulate blood coagulation and immune function. XBJ has been used in severe pneumonia patients in China. Whether it can reduce the mortality of patients is still controversial. This study aimed to analyze the effectiveness of XBJ in the treatment of severe pneumonia. Methods . Databases including PubMed, Cochrane Library, Web of Science, Embase, CNKI, WanFang, and VIP were searched, from inception to February 2020, to identify randomized controlled trials (RCTs) about XBJ combined with western medicine treatment in treating severe pneumonia. Literature screening, data extraction, and methodological quality assessment were carried out by two researchers back‐to‐back. RevMan 5.3 software was used for statistical analysis. Results . A total of 21 articles involving 2072 patients were included. The meta‐analysis showed that treatment combined with XBJ has better efficiency compared with western medicine treatment alone. It could also decrease 28‐day mortality; shorten the length of intensive care unit (ICU) stay time and mechanical ventilation time; and reduce the levels of C‐reactive protein (CRP), procalcitonin (PCT), white blood cell (WBC), tumor necrosis factor‐ α (TNF‐ α ), interleukin‐6 (IL‐6), and D‐dimer in the serum of patients. The incidence of adverse reactions did not increase significantly. Conclusion . XBJ combined with western medicine treatment has significant clinical efficacy and no obvious adverse reactions. A dose of 100 ml bid is recommended to reduce 28‐day mortality. The conclusion needs to be further verified with larger‐sample size and higher‐quality RCTs.