Effect of shenfu injection in patients with septic shock: A systemic review and meta-analysis for randomized clinical trials

Jiaojiao Liao; Chenyuan Qin; Zongyu Wang; Ling Gao; Shimo Zhang; Yuting Feng; Jue Liu; Liyuan Tao

doi:10.1016/j.jep.2023.117431

Effect of shenfu injection in patients with septic shock: A systemic review and meta-analysis for randomized clinical trials

J Ethnopharmacol. 2024 Feb 10:320:117431. doi: 10.1016/j.jep.2023.117431. Epub 2023 Nov 19.

Authors

Jiaojiao Liao¹, Chenyuan Qin², Zongyu Wang³, Ling Gao², Shimo Zhang², Yuting Feng⁴, Jue Liu², Liyuan Tao⁵

Affiliations

¹ Clinical Epidemiology Research Center, Peking University Third Hospital, Beijing, 100191, PR China.
² Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, PR China.
³ Department of Critical Care Medicine, Peking University Third Hospital, Beijing, 100191, PR China.
⁴ School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, PR China.
⁵ Clinical Epidemiology Research Center, Peking University Third Hospital, Beijing, 100191, PR China. Electronic address: liyuantao@bjmu.edu.cn.

PMID: 37981120
DOI: 10.1016/j.jep.2023.117431

Abstract

Ethnopharmacological relevance: Shenfu injection (SFI) is a well-known Chinese herbal medicine widely used in the treatment of septic shock in China.

Aim of the study: To explore the clinical safety and effectiveness of combined application of Shenfu injection in the treatment of septic shock on the basis of routine western medical treatment.

Materials and methods: Randomized controlled trials published before February 28, 2022 in patients with septic shock were searched in the Chinese Biomedical Literature Service System (SinoMed), Embase, PubMed, Cochrane Library, WOS, Scopus. Stata 15.0 and R 4.2.2 were used to meta-analyze sequential organ failure assessment (SOFA) score, case fatality rate, mean arterial pressure (MAP), arterial lactate (Lac). Adverse effects were analyzed by description.

Results: A total of 904 articles were searched and 56 RCTs were included, with a total of 4279 participants. Among them, there were 2148 cases in the SFI group and 2131 cases in the control group. The meta-analysis showed that, comparing with routine western medical therapy, the combined use of SFI could effectively reduce 24 h SOFA (MD = -0.79, 95%CI: (-1.12) - (-0.46)), 72 h SOFA (MD = -1.53, 95%CI: (-1.89) - (-1.17)) and 7 d SOFA (MD = -1.55; 95%CI: (-2.86) - (-0.24)). Besides, combined use of SFI could reduce 14 d case fatality rate (RR = 0.16, 95% CI: 0.07-0.37) and 28 d case fatality rate (RR = 0.82, 95% CI: 0.71-0.95). While SFI group showed almost the same effect in 7 d case fatality rate as control (RR: 0.76; 95% CI: 0.42-1.37; P = 0.37). SFI could increase 6 h MAP (MD = 6.40, 95% CI: 3.43-9.37) and 24 h MAP (MD = 4.79, 95% CI: 1.62-7.95). Additionally, SFI could decrease 6 h Lac (MD = -0.90, 95% CI: (-1.34) - (-0.45)), 24 h Lac (MD = -0.80, 95% CI: (-1.20) - (-0.40)), 48 h Lac (MD = -0.67, 95% CI: (-1.05) - (-0.29)).

Conclusions: Shenfu injection combined with RWT showed better therapeutic effect than RWT. SFI plus RWT can improve clinical prognosis of patients with septic shock.

Keywords: Effectiveness; Meta-analysis; Safety; Septic shock; Shenfu injection (SFI).

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Drugs, Chinese Herbal* / adverse effects
Humans
Lactic Acid
Prognosis
Randomized Controlled Trials as Topic
Shock, Septic* / drug therapy

Substances

Shen-Fu
Drugs, Chinese Herbal
Lactic Acid