Effect of traditional Chinese medicine on intra-abdominal hypertension and abdominal compartment syndrome: A systematic review and Meta-analysis.

Objective: Traditional Chinese medicine (TCM) recently become a widely used treatment option for treating intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS). However, we still lack large-scale, high-quality, randomized controlled trials (RCTs). The purpose of this systematic review was to evaluate the existing clinical trials and to provide additional specific evidence.

Methods: A systematic review of randomized controlled trials (RCTs) of TCM for IAH/ACS was conducted. The following databases were searched to identify relevant studies: PubMed, Medline (Ovid SP), The Cochrane Library, China Biology Medicine Database, Wanfang Database, Chinese Periodical Database, Chinese Clinical Trial Registry, and China Knowledge Resource Integrated Database. Meta-analysis was performed using Rev. Man 5.3.

Results: Fifteen studies involving 735 participants were included in the analysis. Compared to conventional therapy, TCM has a significant effect on reducing intra-abdominal pressure (IAP) [15 studies, 700 patients, standard mean difference (SMD)=-0.93, 95% credibility interval (CI): -1.35- -0.52], improving the APACHE II (five studies, 199 patients, SMD=-0.75, 95% CI: -1.30- -0.21), and shortening the length of hospitalization (LOH) (six studies, 214 patients, SMD=-1.21, 95% CI: -1.50- -0.91). The influence of mortality (six studies, 241 patients) was not significant [The pooled risk ratio (RR) was -0.07 (95% CI: -0.17- 0.03)].

Conclusions: TCMs seem to be effective for patients with IAH and ACS; however, most of the reviewed trials are of poor quality. Large-scale, high-quality clinical trials are warranted.