Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China.
Medicine (Baltimore). 2022 Oct 21;101(42):e31196. doi: 10.1097/MD.0000000000031196.
Xuebijing injection (XBJ) has increasingly been used for sepsis in China. We aimed to evaluate the methodological quality and summarize the evidence regarding the effectiveness of XBJ combined with ulinastatin (UTI) for sepsis from systematic reviews/meta-analyses (SRs/MAs).
From the inception to May 23, 2021, eight databases were searched to screen the SRs/MAs of XBJ combined with UTI in the treatment of sepsis. Methodology Quality of Systematic Reviews 2 (AMSTAR-2) was used to evaluate the quality of the methods. Grading of Recommendation,Assessment, Development, and Evaluation (GRADE) was used in the assessment of evidence quality.
Seven SRs/MAs on XBJ combined with UTI treatment for sepsis were included. The AMSTAR-2 showed that the methodological quality of all included SRs/MAs was rated as critically low. According to the evaluation results of GRADE, 30% (13/44), 30% (13/44), and 40% (18/44) were rated to be of moderate, low, and critically low quality, respectively. Descriptive analysis results showed that XBJ combined with UTI was an effective treatment modality for sepsis.
All included SRs/MAs showed that XBJ combined with UTI was more effective than UTI alone in the treatment of sepsis on the basis of conventional treatment, but the reliability of the results was limited due to the disadvantages of lower methodological quality and higher risk of bias in the included SRs/MAs. Further high-quality clinical studies and SRs/MAs are recommended to verify whether XBJ combined with UTI is more effective than UTI alone.
血必净注射液（XBJ）在中国被越来越多地用于治疗脓毒症。我们旨在评估系统评价/荟萃分析（SRs/MAs）中关于 XBJ 联合乌司他丁（UTI）治疗脓毒症的有效性的方法学质量并总结证据。
从创建到 2021 年 5 月 23 日，我们检索了八个数据库，以筛选 XBJ 联合 UTI 治疗脓毒症的 SRs/MAs。采用系统评价方法学质量评估工具 2（AMSTAR-2）评价方法的质量。采用推荐、评估、制定和评价分级（GRADE）评估证据质量。
纳入了 7 项关于 XBJ 联合 UTI 治疗脓毒症的 SRs/MAs。AMSTAR-2 显示，所有纳入的 SRs/MAs 的方法学质量均被评为极低级。根据 GRADE 的评估结果，30%（13/44）、30%（13/44）和 40%（18/44）分别被评为中度、低和极低级质量。描述性分析结果表明，在常规治疗的基础上，XBJ 联合 UTI 是治疗脓毒症的有效治疗方法。
所有纳入的 SRs/MAs 均表明，在常规治疗的基础上，XBJ 联合 UTI 比单独使用 UTI 更有效，但由于纳入的 SRs/MAs 方法学质量较低和偏倚风险较高，结果的可靠性受到限制。建议开展进一步的高质量临床研究和 SRs/MAs，以验证 XBJ 联合 UTI 是否比单独使用 UTI 更有效。
