Xuebijing injection for acute organophosphorus pesticide poisoning: a systematic review and meta-analysis.

BACKGROUND

To evaluate the efficacy and safety of Xuebijing injection (XBJ) treatment for acute organophosphorus pesticide poisoning.

METHODS

Using the PubMed, Cochrane, Embase, Sinomed, Wanfang, CNKI, and Weipu (VIP) databases from the beginning of the datasets until December 2017, all of the relevant randomized controlled trials were identified. Relative risks (RR), weighted mean difference (WMD), along with 95% confidence interval (95% CI) were used to analyze the main outcomes. Statistical analysis was performed using the RevMan software version 5.3. The qualities of the involved studies were assessed by the risk of bias according to the Cochrane handbook.

RESULTS

Twenty-six randomized controlled trials with 1,880 participants were collected in total. Compared with just conventional therapy alone, XBJ combined with conventional therapy significantly reduced the 7-day mortality rate (RR: 0.33; 95% CI: 0.22-0.49), CRP in the 50 mL group (WMD: -11.60; 95% CI: -14.38 to -8.83), CRP in the 100 mL group (WMD: -1.73; 95% CI: -2.91 to -0.55), AChE in the 50 mL group (WMD: -4.58;95% CI: -5.87 to -3.28), AChE in the 100 mL group (WMD: -1.73; 95% CI: -2.07 to -1.39), hospital stays in the 50 mL group (WMD: -4.26; 95% CI: -4.89 to -3.64), TNF-α in the 50 mL group (WMD: -2.66; 95% CI: -4.99 to -0.32), NF-κB in the 50 mL group (WMD: -13.07; 95% CI: -14.67 to -11.47), and CK-MB in the 50 mL group (WMD: -32.28; 95% CI: -40.62 to -23.93). However, there was no statistical difference of TNF-α in the 100 mL group (WMD: -2.17; 95% CI: -4.66 to 0.32).

CONCLUSIONS

XBJ has a significant clinical efficacy for the treatment of patients with acute organophosphorus pesticide poisoning. The most effective dose is 50 mL, while the most effective frequency is twice a day. However, more studies are needed to confirm the extract efficacy of XBJ.