ABSTRACT
To systematically review the efficacy of Xuebijing Injection combined with western medicine in the treatment of systemic inflammatory response syndrome(SIRS). In this study, CBM, CNKI, Wanfang, VIP, PubMed and EMbase databases were retrieved for clinical randomized controlled trials on the effect of Xuebijing Injection combined with western medicine in the treatment of SIRS from the establishment of the database to July 31, 2020. After screening, Meta-analysis was conducted by RevMan 5.3 software, trial sequential analysis was conducted by TSA 0.9.5.10 beta software, and the evidence quality level was evaluated by GRADEprofiler 3.6.1 software. Meta-analysis showed that Xuebijing Injection combined with western medicine could reduce white blood cell count(MD=-2.32, 95%CI[-2.44,-2.21], P<0.000 01), C-reactive protein count(MD=-22.70, 95%CI[-29.61,-15.79], P<0.000 01), APACHE â ¡ score(MD=-2.15, 95%CI[-2.43,-1.87], P<0.000 01), tumor necrosis factor alpha count(SMD=-1.23, 95%CI[-1.48,-0.99], P<0.000 01) and interleukin-6 count(SMD=-0.92, 95%CI[-1.15,-0.69], P<0.000 01), improve treatment efficiency(RR=1.39, 95%CI[1.23, 1.56], P<0.000 01), reduce incidence of multiple organ dysfunction(RR=0.47, 95%CI[0.35, 0.64], P<0.000 01) and mortality(RR=0.22, 95%CI[0.13, 0.37], P<0.000 01), which were better than western medicine treatment alone. Trial sequential analysis showed that in terms of reducing the incidence of multiple organ dysfunction and C-reactive protein count, the cumulative Z value passed through the traditional threshold, TSA threshold and expected information value, and reached the required number of cases. GRADE evaluation showed that the level of evidence was low or very low. According to the findings, Xuebijing Injection combined with western medicine is effective in treating SIRS. However, as the low quality of the included studies may affect the reliability of the conclusion, more high-quality studies shall be included for further verification in the future, so as to provide better suggestions for clinical medication.
Subject(s)
Drugs, Chinese Herbal , Humans , Injections , Randomized Controlled Trials as Topic , Reproducibility of Results , Systemic Inflammatory Response Syndrome/drug therapyABSTRACT
[Objective]To analyze the feasibility and clinical efficacy of one-stage debridement,bone grafting and in-ternal fixation for the treatment of single-segmental lumbar spinal tuberculosis with extreme lateral approach.[Methods]Thirteen patients of single-segmental lumbar spinal tuberculosis that received the surgeries from April 2013 to August 2016 were included.The operation duration and the amount of intraoperative blood loss were recorded.The VAS and ODI of the back pain,lumbar kyphosis angle,segment height restoration,and vertebral fusion rate were used to analyze the clinical efficacy.[Results]Thirteen patients were successfully followed up for 13-32 months(mean,20.3 months);the operation duration was 160-280 min(average,214±96)min;the amount of intraoperative blood loss was 150-350 mL, average(average,263±63)mL. At the final follow-up,ESR and CRP were normal and lower back pain(VAS)and Oswestry disability index(ODI)were significantly reduced(7.2±1.6 vs 2.5±1.2 and 63.3±5.4 vs 31.9±3.7,respectively)compared to preoperative values;there were no significant difference in the lumbar kyphosis angle,segment height resto-ration between preoperation(segmental lordosis,7.1°±4.7°;segmental height,64.8 mm±9.3 mm)and the values at final follow-ups(segmental lordosis,5.2°±3.5°;segmental height,69.4 mm±10.5 mm;P>0.05). All cases acquired good lumbar interbody fusion with no internal fixation failure or recurrence of tuberculosis.[Conclusions]Under systemic and routine antituberculosis chemotherapy,one-stage extreme lateral approach debridement,bone graft and internal fixation is effective and feasible for single-segmental lumbar spinal tuberculosis.