Chinese herbal medicine therapy for hyperlipidemic acute pancreatitis: a systematic review and meta-analysis of randomized controlled trials

OBJECTIVE: Chinese herbal medi-cine (CHM) has been widely used in the treatment of hyperlipidemic acute pancreatitis (HLAP), but the credibility of the evidence for this practice is unclear. We systematically reviewed the efficacy and safety of CHM therapy for HLAP.MATERIALS AND METHODS: In this system-atic review and meta-analysis, we searched the Cochrane Central Register of Controlled Trials, Ovid MEDLINE, PubMed, EMBASE, CBM, CN-KI, VIP, and Wanfang databases from inception to October 16, 2022, for randomized controlled trials comparing the combination of CHM and Western medicine therapy vs. Western medicine therapy alone in HLAP adults. This study is reg-istered with PROSPERO (No. CRD 42022371052).RESULTS: A total of 50 eligible studies involv-ing 3,635 patients were assessed in this me-ta-analysis. Compared with Western medicine therapy, the combination of CHM increased the total effective rate by 19% in HLAP patients [rel-ative risk (RR): 1.19, 95% CI: (1.16, 1.23)]. There were significant differences between the two groups in improving clinical symptoms, promot-ing serum amylase and triglyceride recovery, re-ducing mortality [RR: 0.28, 95% CI: (0.14, 0.56)] and complication rates [RR:0.40, 95% CI: (0.31, 0.52)], and shortening the length of hospital stay [MD:-3.96, 95% CI: (-4.76,-3.16)]. Adverse re-actions were similar between groups. Findings were robust in the sensitivity analysis.CONCLUSIONS: The combined CHM treat-ment was more effective than Western medi-cine alone in HLAP patients. However, due to the methodological shortcoming of the eligible studies, caution is needed when interpreting these findings.