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

ObjectiveThe 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.MethodsWe 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.ResultsA 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.ConclusionsAdjuvant treatment with crude rhubarb appears to have additional benefits in septic patients. Antiinflammation and anticoagulant/antiaggregant properties may be its potential mechanism.