title: 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.
authors.affiliation: Department of Emergency, the Second Affiliated Hospital of Nantong University, Nantong, 226001, China.
authors.forename: Liyuan
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Clinical Medicine, Medical School of Jiangsu University, Zhenjiang, 212001, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Emergency, the People's Hospital Affiliated to Jiangsu University, Zhenjiang, 212002, China.
authors.forename: Dapeng
authors.initials: D
authors.lastname: Jiang
authors.affiliation: Department of Emergency, the Second Affiliated Hospital of Nantong University, Nantong, 226001, China. Electronic address: zhangpengnantong@sina.com.
authors.forename: Peng
authors.initials: P
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002116:Calcitonin / Q000276:immunology; D015740:Calcitonin Gene-Related Peptide; D005260:Female; D006801:Humans; D007249:Inflammation; D015850:Interleukin-6 / Q000276:immunology; D008297:Male; D008875:Middle Aged; D008517:Phytotherapy; D011498:Protein Precursors / Q000276:immunology; D016032:Randomized Controlled Trials as Topic; D012250:Rheum; D018805:Sepsis / Q000188:drug therapy* / Q000276:immunology; D018746:Systemic Inflammatory Response Syndrome / Q000188:drug therapy* / Q000276:immunology; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology; D055815:Young Adult
chemical_list: C000606589:CALCA protein, human; C508600:IL6 protein, human; D015850:Interleukin-6; D011498:Protein Precursors; D014409:Tumor Necrosis Factor-alpha; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide
keywords: Anticoagulant; Antiinflammation; Crude rhubarb; Meta-analysis; Sepsis