Adjuvant treatment with crude rhubarb for patients with systemic inflammation reaction syndrome/sepsis: A meta-analysis of randomized controlled trials

Abstract Objective The objective of this study is to evaluate the benefits of adjuvant treatment with crude rhubarb in patients with systemic inflammation reaction syndrome/sepsis by conducting a meta-analysis. Methods We conducted a systematic literature search of medical electronic databases (up to October 2013). Only randomized controlled trials (RCTs) assessing adjuvant treatment with crude rhubarb in septic patients were included. Results A total of 15 RCTs with 869 patients were identified. Pooled analysis showed that interleukin 6 (standardized mean differences [SMDs], −1.30; 95% confidence intervals [CIs], −1.94 to −0.66), tumor necrosis factor α (SMD, −0.95; 95% CI, −1.55 to −0.36), procalcitonin (SMD, −1.50; 95% CI, −2.20 to −0.80), von Willebrand factor (mean differences [MDs], −144.11; 95% CI, −253.87 to −34.35), prothrombin time (MD, −2.38; 95% CI, −2.67 to −2.10), acute physiology and chronic health evaluation II scores (MD, −4.51; 95% CI, −5.30 to −3.73), and gastrointestinal dysfunction (risk ratio, 0.28; 95% CI, 0.16-0.49) were significantly reduced after treatment with crude rhubarb. Platelet number (MD, 58.16; 95% CI, 51.16-65.15) was significantly increased. However, crude rhubarb therapy did not significantly reduce 28-day mortality (risk ratio, 0.60; 95% CI, 0.36-1.00) compared with the usual treatment. Conclusions Adjuvant treatment with crude rhubarb appears to have additional benefits in septic patients. Antiinflammation and anticoagulant/antiaggregant properties may be its potential mechanism.