Comparative efficacy of traditional Chinese herbal injection for chronic renal failure:A systematic review and network meta-analysis of randomized controlled trials

Objective: To conduct a systematic review and network meta-analysis(NMA) for the comparison of the efficacy and safety of Chinese herbal injection(CHI) combined with Western medicine(WM) and WM monotherapy for chronic renal failure(CRF).Methods: Eight databases were searched from inception to August 30, 2022. Randomized controlled trials(RCTs) regarding the comparison of CHI-WM combination therapy and WM monotherapy were included. Literature search, risk-of-bias assessment, and data extraction were conducted by 2 reviewers independently. NMA was performed by Stata 14.0, R 4.0.4 software, and the latest risk of bias assessment tool 2(RoB 2).Results: A total of 53 RCTs were finally included, involving 4445 participants and 16 CHIs. RoB 2 showed that 2 of these studies had a high risk of bias. Tianqi injection(TQ) + WM was the most effective in reducing serum creatinine(Scr) level. Xingding injection(XD) + WM was the most effective in reducing blood urea nitrogen(BUN) and cystatin C(Cys C) levels. Guhong injection(GH) + WM had the highest endogenous creatinine clearance rate(Ccr). Shuxuetong injection(SXT) + WM was the most effective in improving the clinical effective rate. Danhong injection(DH) + WM resulted in the lowest 24-h urinary protein quantity(24 h-UPQ), while Danshen injection(DS) + WM led to the lowest blood uric acid(UA)level. Shenfu injection(SF) + WM was the most effective in increasing hemoglobin(Hb) level.Conclusion: CHIs-WM combination therapy is more effective than WM monotherapy in treating CRF.Considering all of the indicators, SK + WM may be the optimal treatment option for improving renal function in patients with CRF.

A review on the Pharmacology and Adverse Drug Reaction of Chaihu Herbal Injection

The Chaihu herbal injection was the first herbal injection to be developed and used in China,which has been used in clinic for more than 70 years.This injection is widely used to treat fever caused by influenza or common cold and malaria.However,there is an ongoing debate about the safety of the clinical use of Chaihu herbal injection in view of the large number of adverse drug reaction reports and literature in China.On May 29,2018,the China Food and Drug Administration issued a notice requiring to revise the instruction manual of Chaihu herbal injection,list"prohibit for children"under the taboo item,and add the warning"adverse reactions of this product include anaphylactic shock".The purpose of this review is to provide updated,comprehensive information on the pharmacology and adverse drug reaction of Chaihu herbal injection based on scientific literatures in the past few decades.

Application of microcalorimetry of Escherichia coli growth and discrimin antanalysis to the quality assessment of a Chinese herbal injection(Yinzhihuang)

This paper describes a novel approach to the quality control of a Chinese herbal injection based on microca lorimetric determination of its effect on the biothermal active fingerprint(BTAF)of Escherichia coli(E.coli)growth.Yinzhihuang Injection(YZHI)was selected for this proof of concept study.Reference samples of Y ZHI were collected and compared with test(stressed)samples prepared under different stress conditions.The BTAF of E.coli growth was found to be affected by YZHI and the changes were analyzed on the basis of eleven biothermokinetic parameters.Similarity and multivariate statistical analysis were used to investi-gate the differences between reference and test samples and discriminant analysis was used to delineate the altered samples.Reference samples were found to have coincident BTAFs with similarity index>0.99.Stressed samples showed differences in the BTAF which increased in line with decreased quality.Discriminant formulae were developed based on a sensitivity parameter which could identify all altered samples.In conclusion,BTAF can be used to assess the quality of YZHI both qualitatively and quantitatively and has the potential to provide a sensitive method for quality control of Chinese herbal injections.

Ineffectiveness of Skin Tests in Predicting Allergic Reactions Induced by Chinese Herbal Injections

Objective:To evaluate whether skin tests are suitable to predict the allergy reactions induced by Chinese herbal injections(CHIs).Methods:The skin tests including skin prick tests(SPT),intradermal tests(IDT)and provocation tests including subcutaneous tests and intravenous tests were administered to 249 healthy subjects and 180 allergic patients for 3 CHIs,including ginkgolide injection,diterpene ginkgolide meglumine injection and Salvianolate lyophilized injection.The results of the provocation tests were used as the"gold standard"to determine the sensitivity and specificity of the skin tests.Results:The results did not show any significant differences between the healthy and allergy groups in both skin tests and provocation tests(P>0.05).The specificities of SPT and IDT were 0.976 and 0.797,respectively,and the sensitivities of both SPT and IDT were 0.Conclusion:Skin tests are insufficient to predict the likelihood of allergic reactions resulting from CHIs.(ChiCTR-CPC-15006921)