The effect of Chinese herbal medicine on hemorrhagic shock: A systematic review and meta-analysis

Background: Chinese herbal medicine (CHM) has been widely used in the treatment of hemorrhagic shock (HS) in China. Many controlled trials have been undertaken to investigate its efficacy. Objective: To evaluate the effectiveness and safety of CHM for Hemorrhagic Shock patients. Methods: We screening the Web of ScienceDirect database, PubMed, the Cochrane Library, EMBASE, China Biomedical Database web (CBM), China National Knowledge Infrastructure (CNKI) and WanFang database (WF), from inception to January 2015. All the randomized controlled trials (RCTs) that compared CHM plus conventional therapy with conventional therapy alone for HS patients were included. Meta -analysis on included studies was performed using fixed-effects model with RevMan 5.2. Risk ratio (RR) or mean difference (MD) with a 95% confidence interval (CI) was used as effect measure. STATA 12.0 was used for publication bias. Results: Fifteen RCTs involving 1076 participants were included in the meta -analysis. CHM combined with conventional therapy was tested to be more effective in reduce mortality (RR= 0.24, 95%CI:0.13-0.46, P< 0.0001), reduce the incidence of MODS (RR= 0.47, 95%CI: 0.34-0.66,P< 0.00001), symptomatic improvement: increase blood pressure (BP) (MD= 8.83, 95%CI:6.82-10.84,P < 0.00001), regulate heart rate (MD = 7.6,95%CI-9.17 to -6.02,P < 0.00001), increase urine volume (MD = 7.26, 95%CI:5.00-9.53, P <0.00001), compared with conventional therapy alone. No serious adverse events were reported. Conclusions: CHM combined with conventional therapy seems to be more effective on HS patients. However, the analysis results should be interpreted with caution due to the low methodological quality of the included trials. Future, the rigorously designed, high methodological quality, multicenter and large-scale trials are needed to confirm these conclusions. (C) 2016 Elsevier Ltd. All rights reserved.