Efficacy of Xuebijing injection for the treatment of acute lung injury: A meta-analysis of randomized controlled trials

BackgroundManagement guidelines for acute lung injury (ALI) are extremely limited. Xuebijing, a traditional Chinese medicine, exerts therapeutic effects in patients with ALI; however, supportive evidence is currently insufficient.Material and MethodsA systematic literature search of seven electronic databases for randomised controlled trials assessing the efficacy of Xuebijing injections in patients with ALI, published from inception to March 31, 2024, was performed. The Risk of Bias assessment tool recommended by The Cochrane Collaboration was used for quality evaluation. Review Manager version 5.3 (R Foundation for Statistical Computing, Vienna, Austria) was used for analysis. Dichotomous variables are expressed as relative risk (RR) and continuous variables as standardised mean difference (SMD). Heterogeneity was assessed using the I2 statistic and a funnel plot was used to visually assess publication bias.ResultsSixteen studies comprising 1327 patients were included. Xuebijing injection improved oxygenation index (SMD 1.08 [95% confidence interval (CI) 0.79–1.38]), reduced the incidence of acute respiratory distress syndrome (RR 0.56 [95% CI 0.42–0.74) and all-cause mortality (RR 0.48 [95% CI 0.34–0.67]), and decreased serum tumor necrosis factor-alpha (SMD -1.33 [95% CI -1.50 to -1.17]) and interleukin-6 levels (SMD -1.35 [95% CI -1.52 to -1.17]). The funnel plot indicated no publication bias.ConclusionXuebijing injection may be an effective treatment for ALI. However, this needs to be further confirmed in well-designed, large-sample, randomised controlled trials.