Review Article

Adjuvant Application of Shenmai Injection for Sepsis: A Systematic Review and Meta-Analysis

Table 1

Characteristics of included studies.

First author, yearSample size (E/C)AgeInterventionTreatment courseOutcome
ExperimentalControl

Bao Jifeng, 2015 [12]112 (56/56)60.34 ± 4.31 (23–85)Patients with hypotension: regular treatment+SI 100 ml/dRegular treatment7 dCoagulation: PT, TT, APTT, FIB, PLT, D-D
Patients without hypotension: regular treatment+SI 60 ml/dImmune: CD3, CD4, NK
Inflammation:TNF-α, IL-1β, IL-6, IL-8, CRP
Organ: ALT, AST, BUN, Cr, LDH, CK, CK-MB
Chen Tengfei, 2020 [13]62 (28/34)61–91/67–95Regular treatment+SI 200 ml/dRegular treatment7 d28-day mortality
Inflammation: PCT, CRP
Chen Wei, 2017 [14]80 (40/40)69.15 ± 5.62/69.23 ± 5.44Regular treatment+SI 40 ml/dRegular treatment1028-day mortality, case fatality rate
Chen Yuzhi, 2015 [15]50 (25/25)71.84 ± 15.17/73.40 ± 9.5Regular treatment+SI 100 ml/dRegular treatment5–7 dCase fatality rate, APACHE II score
Coagulation: APTT, PT, AT, D-D, FIB, PLT;
WBC, HB
Feng Gang, 2019 [16]66 (33/33)62.14 ± 18.72/61.78 ± 17.33Regular treatment+SI 24-hour continuous infusion 10 ml/h (240 ml/d)Regular treatment7 dAPACHE II score
Inflammation: TNF-α, CRP, IL-6
He Cong, 2019 [17]32 (16/16)59.75 ± 8.66/61.19 ± 8.26Regular treatment+SI 200 ml/dRegular treatment7 d28-day mortality
Organ: BNP, TnI, CK-MB
Huang Zengfeng, 2010 [18]60 (30/30)61.5 ± 8.7/60.8 ± 9.2Regular treatment+SI 100 ml/dRegular treatment7 dAPACHE II
Inflammation: TNF-α, IL-1β, IL-6, IL-8, IL-10
Liu Linlin 2012 [19]63 (31/32)60–89Regular treatment+SI 40 ml/dRegular treatment7 d28-day mortality rate
Organ:CK-MB, BNP, Cr
Coagulation: PA, APTT, Hb
Li Wansheng, 2018 [20]100 (50/50)58.93 ± 5.46/59.73 ± 5.13Regular treatment+SI 60 ml/dRegular treatment7 dAPACHE II score
Coagulation: PLT, FIB, APTT
Liu Wenyue, 2018 [21]106 (53/53)66.73 ± 4.8/67.04 ± 4.75Regular treatment+SI 100 ml/dRegular treatment7 dCase fatality rate; APACHE II score
Organs: BNP, CK, CK-MB, TnI
Immune: CD4+, CD8+, NK
Ning Xiaoping, 2011 [22]60 (30/30)56.9 ± 2.3 (23–78)Regular treatment+SI 60 ml/dRegular treatment7 dCase fatality rate, APACHE II score
Organ: Cr
Coagulation: PLT
Ning Xiaoping, 2012 [23]60 (30/30)58.2 ± 3.6Patients with hypotension: regular treatment+SI 100 ml/dRegular treatment7 dInflammation: TNF-α, IL-1, CRP
Patients without hypotension: regular treatment+SI 60 ml/d
Shen Liming, 2014 [24]46 (23/23)67.2 ± 8.1/65.5 ± 7.9Regular treatment+SI 100 ml/dRegular treatment7 dFatality rate, APACHE II score
Inflammation: CD3, CD4, CD8, CD4/CD8, NK
Wang Baohua, 2021 [25]84 (42/42)55.87 ± 5.24/56.32 ± 4.58Patients with hypotension: regular treatment +CBP+SI 60 ml/dRegular treatment+CBP7 dAPACHE II score, case fatality rate; AE
Patients without hypotension: regular treatment +CBP+SI 100 ml/dInflammation: CRP, PCT
Coagulation: PT, TT, APTT, D-D
Wang Sen, 2016 [26]96 (48/48)69.15 ± 5.24/68.94 ± 5.17Patients without hypotension:regular treatment+SI injection 120 ml/dRegular treatment7 dAPACHE II score; AE
Patients with hypotension:regular treatment+SI 200 ml/dInflammation: CRP, PCT, TNF-α
Xu Wei, 2017 [27]60 (30/30)68.56 ± 3.39/69.34 ± 2.57Regular treatment+SI 50 ml/dRegular treatment7 dAE
Organ: BNP, CK-MB, TnI
Xu Xiaoyun, 2015 [28]80 (40/40)60.8 ± 9Regular treatment+SI 24-hour continuous infusion 10 ml/h (240 ml/d)Regular treatment7 dAE
Organ: ALT, AST, BUN, Cr, CK, CK-MB
Inflammation: CRP, PCT, TNF-α, IL-6, IL-8, WBC
Yao Yabin, 2017 [29]82 (41/41)54.12 ± 11.18/51.27 ± 11.35Regular treatment+SI 100 ml/dRegular treatment7 dCase fatality rate, APACHE II score; AE
Yu Limei, 2016 [30]70 (35/35)58.31 ± 3.21/59.12 ± 3.32Regular treatment+SI 40 ml/dRegular treatment7 dAE
Inflammation: CRP, TNF-α, IL-1, IL-6
Zeng Dao, 2013 [31]50 (25/25)50 ± 2.5 (24–75)Patients with hypotension: regular treatment+SI 100 ml/dRegular treatment10 dAE
Patients without hypotension: regular treatment+SI 60 ml/dInflammation: TNF-α, IL-6, CRP
Zhou Yuanshen, 2016 [32]50 (25/25)72.62 ± 12.53Regular treatment+SI 100 ml/dRegular treatment7 d28-day mortality rate; APACHE II score
Coagulation:APTT, PT, D-D, FIB, PLT, WBC, Hb

Note. SI, Shenmai injection; AE, adverse events; CRP, C-reaction protein; IL-6, interleukin-6; NK, natural killer; ALT, alanine transaminase; AST, aspartate transaminase; BUN, blood urea nitrogen; Cr, creatinine; LDH, lactate dehydrogenase; CK, creatine kinase; CK-MB, creatine kinase isoenzyme-MB; APTT, activated partial thromboplastin time; PT, prothrombin time; TT, thrombin time; FIB, fibrinogen; PLT, platelet; D-D, D-dimer; IL-1, interleukin-1; TNF-α, tumor necrosis factor-α; IL-8, interleukin-8; WBC, white blood cell; Hb, hemoglobin; BNP, B-brain natriuretic peptide; TnI, troponin I. Regular treatment of sepsis may include fluid resuscitation, anti-infection, serum sugar control, maintenance of homeostatic equilibrium, mechanical ventilation, and comprehensive therapy such as nutrition support and administration of glucocorticoids.