Abstract
Background and Aim Spontaneous bacterial peritonitis (SBP) is one of the most common complications of liver cirrhosis. Antibiotics are the main treatment regimen of SBP. Traditional Chinese medicine Xuebijing injection has been used in such patients. Our study aimed to overview the efficacy of Xuebijing injection combined with antibiotics for the treatment of SBP. Method We searched the PubMed, Embase, China National Knowledge Infrastructure, VIP, and Wanfang databases. The search items included “Xuebijing”, “peritonitis”, “liver cirrhosis”, and “random” to identify all relevant randomized controlled trials (RCTs). The Cochrane risk of bias tool was used to assess the study quality. The odd ratios (ORs) with 95% confidence intervals (CIs) were calculated by using a random-effect model. Heterogeneity was also calculated. Results A total of 9 RCTs were included. The study quality was unsatisfied. The overall (OR = 2.95, 95% CI = 1.97–4.42, p < 0.00001) and complete (OR = 2.18, 95% CI = 1.57–3.04, p < 0.00001) responses were significantly higher in the Xuebijing injection combined with antibiotics group than the antibiotics alone group. The incidence of cirrhosis related complications, including hepatic encephalopathy and hepatorenal syndrome, was lower in the Xuebijing injection combined with antibiotics group than the antibiotics alone group. No significant heterogeneity was observed among studies. Conclusion Additional use of Xuebijing injection may improve the efficacy of antibiotics for the treatment of SBP in liver cirrhosis. However, due to a low level of current evidence, we did not establish any recommendation regarding the use of Xuebijing injection for the treatment of SBP.
Highlights
Patients with liver cirrhosis are prone to bacterial infection, principally including spontaneous bacterial peritonitis (SBP) [1] and urinary tract infection [2]
It has been reported that empirical antibiotics for the treatment of Spontaneous bacterial peritonitis (SBP) may fail in almost 60% of patients and that 40% of patients with an initial response to empirical antibiotics may need to change the type of antibiotics [23]
Our study found that the complete response rate of antibiotics for SBP was 30.0%
Summary
Patients with liver cirrhosis are prone to bacterial infection, principally including spontaneous bacterial peritonitis (SBP) [1] and urinary tract infection [2]. SBP is a common and serious complication in cirrhotic patients with ascites [3]. A previous systematic review by our study group showed that Xuebijing injection was the most commonly used traditional Chinese medicine drug for the treatment of SBP [10]. Xuebijing injection is primarily based on the ancient bloodregulating formula proposed by Dr Qingren Wang, a famous traditional Chinese medicine physician. It includes Honghua, Red Peony Root, Chuanxiong Root, Danshen Root, and angelica sinensis [11], which can promote blood circulation and remove blood stasis. The efficacy and safety of Xuebijing injection for the treatment of SBP in liver cirrhosis remains unclear. Our study aimed to further explore this issue using the method of systematic review and meta-analysis
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