title: The effect of Chinese herbal medicine on hemorrhagic shock: A systematic review and meta-analysis.
abstract: BACKGROUND
  Chinese herbal medicine (CHM) has been widely used in the treatment of hemorrhagic shock (HS) in China. Many controlled trials have been undertaken to investigate its efficacy.
  
  
  OBJECTIVE
  To evaluate the effectiveness and safety of CHM for Hemorrhagic Shock patients.
  
  
  METHODS
  We screening the Web of ScienceDirect database, PubMed, the Cochrane Library, EMBASE, China Biomedical Database web (CBM), China National Knowledge Infrastructure (CNKI) and WanFang database (WF), from inception to January 2015. All the randomized controlled trials (RCTs) that compared CHM plus conventional therapy with conventional therapy alone for HS patients were included. Meta-analysis on included studies was performed using fixed-effects model with RevMan 5.2. Risk ratio (RR) or mean difference (MD) with a 95% confidence interval (CI) was used as effect measure. STATA 12.0 was used for publication bias.
  
  
  RESULTS
  Fifteen RCTs involving 1076 participants were included in the meta-analysis. CHM combined with conventional therapy was tested to be more effective in reduce mortality (RR=0.24, 95%CI:0.13-0.46, P<0.0001), reduce the incidence of MODS (RR=0.47, 95%CI: 0.34-0.66,P<0.00001), symptomatic improvement: increase blood pressure (BP) (MD=8.83, 95%CI:6.82-10.84,P<0.00001), regulate heart rate (MD=-7.6,95%CI:-9.17 to -6.02,P<0.00001), increase urine volume (MD=7.26, 95%CI:5.00-9.53, P<0.00001), compared with conventional therapy alone. No serious adverse events were reported.
  
  
  CONCLUSIONS
  CHM combined with conventional therapy seems to be more effective on HS patients. However, the analysis results should be interpreted with caution due to the low methodological quality of the included trials. Future, the rigorously designed, high methodological quality, multicenter and large-scale trials are needed to confirm these conclusions.
authors.affiliation: Graduate School, Dalian Medical University, Dalian, Liaoning 116044, China.
authors.forename: Da-Long
authors.initials: DL
authors.lastname: Wang
authors.affiliation: Emergency Department, Affiliated Zhongshan Hospital of Dalian University, #6, Jiefang Street, ZhongShan district, Dalian, 116001, China. Electronic address: dllxg@126.com.
authors.forename: Xiao-Guang
authors.initials: XG
authors.lastname: Lu
authors.affiliation: Graduate School, Dalian Medical University, Dalian, Liaoning 116044, China.
authors.forename: Wen-Xiu
authors.initials: WX
authors.lastname: Guo
authors.affiliation: Graduate School, Dalian Medical University, Dalian, Liaoning 116044, China.
authors.forename: Tuo
authors.initials: T
authors.lastname: Chen
authors.affiliation: Emergency Department, Affiliated Zhongshan Hospital of Dalian University, #6, Jiefang Street, ZhongShan district, Dalian, 116001, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Song
authors.affiliation: Emergency Department, Affiliated Zhongshan Hospital of Dalian University, #6, Jiefang Street, ZhongShan district, Dalian, 116001, China.
authors.forename: Zhi-Wei
authors.initials: ZW
authors.lastname: Fan
mesh_terms: D000293:Adolescent; D000328:Adult; D002681:China; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D012771:Shock, Hemorrhagic / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D004365:Drugs, Chinese Herbal
keywords: Chinese herbal medicine; Hemorrhagic shock; Meta-analysis; Systematic review