The effect of Chinese herbal medicine on non-biliogenic severe acute pancreatitis: A systematic review and meta-analysis

Ethnopharmacological relevance: More and more clinicians and researchers have realized that clinical trials are necessary to define clinical efficacy effect. Even though the number has been substantially growing for the past years, the finished and reported trials are limited. Nevertheless, those documented trials are important and precious, and comprehensive evaluation and analysis of them are warranted at current stage. Our goal was to evaluate the effect of Chinese herbal medicine (CHM) on non-biliogenic severe acute pancreatitis (SAP) by conducting a systematic review and meta-analysis of prospective randomized controlled studies. Methods: Relevant studies were identified by PubMed, Cochrane Library, EMBASE, China Biomedical Database web (CBM), China National Knowledge Infrastructure Databases (CNKI), and Wanfang database up to 2014.Reference lists of retrieved articles were also reviewed. Two reviewers independently assessed studies for inclusion and extracted data. The main outcome data of trials were analyzed by using RevMan5.2. Odds ratio (OR) or mean difference (MD) with a 95% confidence interval (CI) was used as effect measure. Either a fixed or a random-effect model was used to evaluate the effect of CHM on non-biliogenic SAP. Results: Twenty two prospective randomized controlled studies involving 1388 participants were included in the meta-analysis. CHM was tested to be more effective than reference group: Mortality [OR: 0.43, 95% CI (029, 0.64)], overall efficiency [OR: 4.0, 95% CI (2.72, 5.89)], operability [OR: 0313, 95% CI (0.21, 0.46)], rate of complications [OR: 037, 95% CI (0.27, 0.50)], Length of hospitalization [MD: -9.70, 95% CI (-12.88, -6.51)] compared with reference group. Conclusions: No serious adverse events were reported. This meta-analysis provides evidence suggesting that CHM seems to be an effective and safe treatment for people with non-biliogenic severe acute pancreatitis (SAP). However, the poor methodological quality of most of the trials means that we may be unable to reach a definitive conclusion. Hence, the effect of CHM in the treatment of non-biliogenic SAP warrants rigorously designed, multicentre, large-scale trials with higher quality worldwide. (C) 2014 Elsevier Ireland Ltd. All rights reserved.