Xuebijing for paraquat poisoning

Paraquat is a non-selective herbicide and is commonly used worldwide. At present, there is a lack of effective drugs for people with paraquat poisoning. Xuebijing injection is a complex traditional Chinese preparation consisting of Flos Carthami, Radix Paeoniae Rubra, Rhizoma Chuanxiong, Radix Salviae Miltiorrhizae and Radix Angelicae Sinensis. This review aimed to assess the effects of Xuebijing injection in people with paraquat poisoning. We identified two trials including 84 people. Although there were fewer deaths in people treated with Xuebijing injection, meta-analysis showed that it did not have a statistically significant benefit on reducing all-cause mortality in people with paraquat poisoning. Both included studies involved small numbers of participants and were considered to be of poor methodological quality. Xuebijing injection may be effective for people with paraquat poisoning, but the effects need to be proven by more high quality evidence.

Authors' conclusions: 

Based on the findings of two small RCTs, Xuebijing injection did not have a statistically significant benefit on reducing all-cause mortality in people with paraquat poisoning. However, both included studies involved small numbers of participants and were considered to be of poor methodological quality. The results are imprecise and easily compatible with the play of chance. Xuebijing injection may be effective for people with paraquat poisoning; however, this needs to be proven by further high-quality evidence.

Read the full abstract...
Background: 

At present, there is a lack of effective treatments for paraquat poisoning. Xuebijing injection is a complex traditional Chinese prescription consisting of Flos Carthami, Radix Paeoniae Rubra, Rhizoma Chuanxiong, Radix Salviae Miltiorrhizae and Radix Angelicae Sinensis. Although clinical experience suggests that Xuebijing injection might have potential in the management of paraquat poisoning, there is no conclusion on the effectiveness of this treatment.

Objectives: 

To assess the effects of Xuebijing injection in patients with paraquat poisoning.

Search strategy: 

We searched the Cochrane Injuries Group's Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), MEDLINE (OvidSP), EMBASE (OvidSP), CINAHL (EBSCO), ISI Web of Science: Science Citation Index Expanded, ISI Web of Science: Conference Proceedings Citation Index-Science, Chinese bio-medical literature and retrieval system (CBM), China National Knowledge Infrastructure Database (CNKI), and the Traditional Chinese Medicine Database. The search was run on the 29th May 2013.

Selection criteria: 

We included all randomised controlled trials (RCTs) comparing Xuebijing injection combined with conventional care against conventional care alone.

Data collection and analysis: 

Two or three authors independently selected studies, assessed study quality and extracted data. We calculated the mortality risk ratio (RR) and 95% confidence interval (CI). Data on all-cause mortality at the end of follow-up were summarised in a meta-analysis.

Main results: 

We identified two trials including 84 people. Although there were fewer deaths in people treated with Xuebijing injection, meta-analysis showed that it did not provide a statistically significant benefit in reducing all-cause mortality in people with paraquat poisoning as compared to control (RR 0.71; 95% CI 0.48 to 1.04; P = 0.08).

Share/Save