Clinical Evidence for Adding Chaiqin Chengqi Decoction to Acute Pancreatitis Care: A Systematic Review and Meta-analysis of Randomized Trials

= 0%). CQCQD was also associated with lower C-reactive protein (SMD = -2.55, 95% CI: -3.41 to -1.69), interleukin-6 (SMD = -1.76, 95% CI: -2.30 to -1.22), serum amylase (SMD = -2.22, 95% CI: -3.04 to -1.39), and Acute Physiology and Chronic Health Evaluation II scores (SMD = -2.08, 95% CI: -3.36 to -0.80), and with a higher CD4+/CD8+ ratio (SMD = 1.41, 95% CI: 0.48-2.35). However, heterogeneity was substantial for all continuous outcomes, most trials were at high risk of bias, and GRADE certainty was low or very low. Patient-important outcomes, including mortality, persistent organ failure, major complications, and pain, were inconsistently reported and could not be reliably pooled. Overall, adjunctive CQCQD was associated with favorable short-term response, laboratory, and severity outcomes, but the available evidence does not establish reductions in mortality, persistent organ failure, or major complications. More rigorous multicenter trials using standardized CQCQD formulations and consistent patient-important endpoints are required.