Clinical evaluation on xiyanping injection in the treatment of bronchopneumonia in children based on meta-analysis

Abstract

Objective: The aim of this study is to evaluate the effectiveness and safety of xiyanping injection (XYPI) in the treatment of children with bronchopneumonia. Methods: A systematic and comprehensive search was conducted in the domestic and foreign electronic databases CNKI, SinoMed, VIP, WanFang DATA, PubMed, The Cochrane Library, Embase, Web of Science, Clinical-Trials.gov, and the search date ended on May 30, 2019. Inclusion criteria: (1) the types of studies included were randomized controlled trials; (2) the study participants were infants and children with a clear diagnosis of bronchopneumonia, without gender and ethnic restrictions; (3) the intervention test group was XYPI or the control group plus XYPI. The control group was routine treatment (RT) (basic treatment such as fever, cough and asthma, oxygen inhalation, anti-infection, maintaining water, electrolyte balance, etc.) or other Western medicine or RT + other Western medicine treatment. Except for XYPI, the two groups were consistent in intervention measures. According to the Cochrane Handbook, 5.1 evaluation standard and a meta-analysis of the final included studies was performed using RevMan 5.3 software. Results: A total of 57 studies were included, with a total sample size of 8454 cases, of which 4255 were in the experimental group and 4199 were in the control group. Meta-analysis results showed that (1) Total effective rate: XYPI group was better than the control group (relative risk [RRRT] = 1.25, 95% confidence interval [CI] [1.15, 1.36], P < 0.00001; RRRT+RBVI= 1.18, 95% CI [1.09, 1.29], P < 0.0001; RR antibiotic= 1.16, 95% CI [1.09, 1.24], P < 0.00001, RRRT+antibiotic= 1.22, 95% CI [1.16, 1.27], P < 0.00001); antipyretic time: XYPI group was better than the control group (mean difference [MDRT] = -0.97, 95% CI [-1.17, -0.76], P < 0.00001; MDRT+antibiotic= -2.28, 95% CI [-2.88, -1.67], P < 0.00001; MDRT+RBVI= -1.51, 95% CI [-1.81, -1.21], P < 0.00001; cough disappearing time: XYPI group was better than the control group (MDRT= -1.37, 95% CI [-1.74, -1.00], P < 0.00001; MDRT+antibiotic= -1.71, 95% CI [-2.04, -1.37], P < 0.00001; MDRT+RBVI= -1.51, 95% CI [-2.15, -0.86], P < 0.00001); disappearance time of lung rales: XYPI group was better than the control group (MDRT= -1.11, 95% CI [-1.35, -0.88], P < 0.00001; MDRT+ RBVI= -1.63, 95% CI [-2.23, -1.03], P < 0.00001). The difference was statistically significant; (2) Of the 57 studies (a total of 8454 cases), 29 studies reported adverse reactions, of which 18 studies did not find adverse reactions, and 11 studies reported adverse reactions such as nausea, vomiting, and rash after medication in both groups. (3) The funnel chart indicated potential publication bias. Conclusion: Based on the existing clinical evidence, XYPI can have a certain effect on the treatment of children with bronchopneumonia, and it is not yet possible to conclude its safety evaluation. Moreover, due to the low quality of the included studies, this evidence is still used with cautious clinically.