Potential preventive and therapeutic effect of Chinese herb rhubarb (da huang) for intensive care unit/pediatric intensive care unit gastrointestinal failure patients: A protocol for systematic review.

Abstract

INTRODUCTION:

The Chinese herb da huang (DH) (Rhubarb) is commonly used for GIF intensive care unit (ICU)/pediatric intensive care unit (PICU) gastrointestinal failure (GIF) patients in China. However, the potential preventive and therapeutic effect of DH in these patients has not yet been studied systematically.

OBJECTIVES:

The aim of this study was to evaluate the preventive and therapeutic effects of DH in treating ICU/PICU GIF patients with the most recent evidence.

METHODS:

We systematically searched 7 databases from inception to March 30, 2018. RevMan 5.3 software was used to perform a meta-analysis. GRADE methodology was applied to evaluate the quality of evidence for each outcome. The review protocol was registered on PROSPERO (CRD42018092710) in advance.

RESULTS:

Seven studies comprising 788 pediatric or adult participants were included in this analysis. Three indicators, including GIF occurrence rates (gastrointestinal mucosal hemorrhage, enteroplegia), multiple organ dysfunction syndrome (MODS)-related items (occurrence rates of MODS, mortality rates of MODS) and duration in the ICU was analyzed. The GIF occurrence rate meta-analysis result was (RR 0.47, CI 95% 0.37-0.60; P = .95); MODS related items indicator result was (RR 0.44, CI 95% 0.33-0.59; P = .41); ICU duration ICU result was (RR -2.87, CI 95% -3.53--2.21; P = .40). The safety of Chinese herb DH (Rhubarb) remains unclear.

CONCLUSION:

Current evidence suggests that the Chinese herb rhubarb (DH) powder combined with Western medicine was inferior to Western medicine alone in terms of preventive and therapeutic effects in ICU/PICU patients in terms of decreasing GIF occurrence rates (gastrointestinal mucosal hemorrhage and enteroplegia), occurrence rates of MODS, mortality from MODS, and shortened duration time in the ICU/PICU. However, larger sample sizes and rigorously-designed studies are necessary to conclusively determine the association between DH powder and outcomes in ICU/PICU GIF patients.

• Authors: Wei Jin, Xiaohui Guo, Qingjie Li, Xiaoqiong Luo, Juan Zhong, Yang Song, Weiwei Hou, Yucui Guo, Yiwei Li, Junping Luo
• Journal: Medicine (Medicine (Baltimore)) Vol. 99 Issue 20 Pg. e20188 (May 2020) ISSN: 1536-5964 [Electronic] United States
• PMID: 32443339 (Publication Type: Journal Article, Meta-Analysis, Systematic Review)

Chemical References

• Drugs, Chinese Herbal

Topics

• Adult
• Child
• China (epidemiology)
• Drugs, Chinese Herbal (adverse effects, therapeutic use)
• Female
• Gastrointestinal Diseases (drug therapy, pathology)
• Gastrointestinal Hemorrhage (drug therapy, prevention & control)
• Humans
• Intensive Care Units (standards, statistics & numerical data)
• Intensive Care Units, Pediatric (standards, statistics & numerical data)
• Male
• Multiple Organ Failure (epidemiology, mortality)
• Rheum (adverse effects)
• Treatment Outcome