Li Jiaqi, Sun Yihan, Wen Hao, Xiao Boying, Wang Jianming, Li Ziqi, Wang Lei, Yu Meiyu
Department of Trauma Center, The First Hospital of China Medical University, Shenyang, Liaoning, China.
Department of General Surgery, The First Hospital of China Medical University, Shenyang, Liaoning, China.
Front Pharmacol. 2025 May 23;16:1598359. doi: 10.3389/fphar.2025.1598359. eCollection 2025.
Xuebijing (XBJ) is a traditional Chinese medicine widely used in China for managing sepsis, systemic inflammatory response syndrome, and multiple organ dysfunction secondary to severe infections. This study aimed to assess the therapeutic efficacy and safety of XBJ as an adjuvant treatment for () infections through meta-analysis, and to explore its potential mechanisms via integrated pharmacological approaches.
A systematic search was conducted across multiple databases for randomized controlled trials (RCTs) evaluating XBJ in infections up to 9 February 2025. Meta-analyses were conducted to synthesize clinical outcomes, and evidence certainty was assessed using the GRADE framework. Network pharmacology, molecular docking, and molecular dynamics simulations were used to evaluate the interactions between active ingredients of XBJ and protein targets in infections.
A total of 11 RCTs involving 1,035 patients met the inclusion criteria. Meta-analysis demonstrated that XBJ significantly improved clinical outcomes, with a higher overall effective rate (RR = 1.20, 95% CI: 1.13-1.27, < 0.01) and enhanced bacterial clearance (RR = 1.44, 95% CI: 1.23-1.68, < 0.01) compared to conventional treatment alone. Additionally, XBJ treatment was associated with marked reductions in inflammatory markers, including C-reactive protein (CRP) (SMD = -2.12), procalcitonin (PCT) (SMD = -2.28), and white blood cell (WBC) count (SMD = -1.00) (all < 0.01). Notably, no serious adverse drug events were reported. Mechanistic investigations identified three active ingredients of XBJ including scutellarin, salvianolic acid C, and isosalvianolic acid C, as potential modulators of MMP9 and TLR4, suggesting the role of XBJ in attenuating inflammatory responses and improving infection outcomes.
XBJ appears effective and safe as an adjuvant therapy for infections, but further high-quality RCTs are warranted to validate these findings.
https://www.crd.york.ac.uk/prospero/, identifier CRD42023486389.
血必净（XBJ）是一种在中国广泛用于治疗脓毒症、全身炎症反应综合征以及严重感染继发的多器官功能障碍的中药。本研究旨在通过荟萃分析评估血必净作为（）感染辅助治疗的疗效和安全性，并通过综合药理学方法探索其潜在机制。
在多个数据库中进行系统检索，以查找截至2025年2月9日评估血必净在（）感染中的随机对照试验（RCT）。进行荟萃分析以综合临床结果，并使用GRADE框架评估证据确定性。采用网络药理学、分子对接和分子动力学模拟来评估血必净活性成分与（）感染中蛋白质靶点之间的相互作用。
共有11项涉及1035例患者的RCT符合纳入标准。荟萃分析表明，与单纯常规治疗相比，血必净显著改善了临床结果，总体有效率更高（RR = 1.20，95%CI：1.13 - 1.27，<0.01），细菌清除率提高（RR = 1.44，95%CI：1.23 - 1.68，<0.01）。此外，血必净治疗使炎症标志物显著降低，包括C反应蛋白（CRP）（SMD = -2.12）、降钙素原（PCT）（SMD = -2.28）和白细胞（WBC）计数（SMD = -1.00）（均<0.01）。值得注意的是，未报告严重的药物不良事件。机制研究确定了血必净的三种活性成分，包括灯盏花素、丹酚酸C和异丹酚酸C，作为基质金属蛋白酶9（MMP9）和Toll样受体4（TLR4）的潜在调节剂，表明血必净在减轻炎症反应和改善感染结局中的作用。
血必净作为（）感染的辅助治疗似乎有效且安全，但需要进一步的高质量RCT来验证这些发现。
