Here, we present a protocol to analyze the effectiveness and safety of Angong Niuhuang Pill in the treatment of viral encephalitis.
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Method Article
The Adjuvant Efficacy of Angong Niuhuang Pill in the Treatment of Viral Encephalitis: A Meta-Analysis of Randomized Controlled Trials
In This Article
Summary
Abstract
This meta-analysis aims to evaluate the efficacy of Angong Niuhuang Pill (ANP) as an adjuvant therapy in the treatment of viral encephalitis. Seven databases (PubMed, Cochrane Library, Embase, SinoMed, CNKI, VIP and WanFang) were included for literature retrieval from inception to July 2023. Randomized controlled trials comparing ANP plus conventional therapy with conventional therapy alone were eligible. Pooled effect sizes and 95% confidence intervals (CIs) were calculated for evaluating efficacy and safety. Sensitivity analysis and publication bias assessments were performed for analyzing the inconclusiveness of findings. 13 studies involving 1045 cases were included for meta-analysis. Adjuvant treatment with ANP increased the probability of the total effective rate by 17% compared with conventional treatment (Risk ratios (RR) = 1.17, 95%CI [1.08, 1.27]). The disappearance time of clinical syndromes and signs was significantly decreased after adjuvant treatment with ANP, including the time of defervescence (weighted mean difference (WMD) = -1.59, 95%CI [-2.09, -1.09]), the time of consciousness recovery (WMD = -1.79, 95%CI [-2.06, -1.51]), the time of headache disappearance (WMD = -1.51, 95%CI [-1.93, -1.08]), the time of tic disappearance (WMD = -1.88, 95%CI [-2.39, -1.36]). The adjuvant efficacy of ANP for treating viral encephalitis (VE) appears to improve the total effective rate and shorten the disappearance time of clinical syndromes. More high-quality randomized controlled trials (RCTs) are needed to support our findings.
Introduction
Encephalitis is defined as the inflammation of the brain parenchyma with high mortality, characterized by neurological pathological signs, fever, abnormal mental status, and altered electroencephalographic (EEG) and neuroimaging1,2. The incidence of encephalitis ranges between 7 and 15 cases per 100,000 people3,4,5. The cause of approximately half of encephalitis cases is unknown, and viral encephalitis (VE) accounts for about 20% to 50% of diagnosed cases5,6.....
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Protocol
1. Protocol registration
- Register the systemic review.
NOTE: PROSPERO (Table of Materials) was built by National Institute for Health Research for the registration of systematic review. This systemic review protocol has been registered under the number CRD42022301182.
2. Software installation
- EndNote software installation
- Purchase EndNote software and download the exe file as an installation program from EndNote's official website (Table of Materials).
- Decompress the ZIP file. Double-click to start the installer.
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Results
Search results and study characteristics
Systematic retrieval yielded 122 studies and manual searching added 9 relevant literatures. After removing 49 duplicates, 82 studies remained to be screened by abstract and full-text. Ultimately, 13 studies12,13,14,15,16,17,18
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Discussion
This meta-analysis provides evidence that the adjunctive ANP can improve the total effective rate by 17% in patients with VE. Adjuvant therapy with ANP can significantly shorten the disappearance time of positive pathological signs and symptoms. Xingnaojing (XNJ) injection extracted from ANP is widely used for abnormal consciousness associated with encephalopathy. A recent meta-analysis verified the adjunctive effect of XNJ for treating VE, contributing to an increase in the number of cure cases and shortening the time o.......
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Disclosures
The authors declare that there are no conflicts of interest.
Acknowledgements
This work was supported by the National Natural Science Foundation of China (No. 81973919), the National Natural Science Foundation of Guangdong Province (No. 2019A1515011299), and the Innovation and Strong School project of the Department of Education of Guangdong Province (No. 2016KTSCX015).
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Materials
| Name | Company | Catalog Number | Comments |
|---|---|---|---|
| PROSPERO | National Institute for Health and Care Research | https://www.crd.york.ac.uk/PROSPERO/ | |
| STATA | StataCorp | https://www.stata.com/ | |
| TSA | Copenhagen Trial Unit, Centre for Clinical Intervention Research | https://ctu.dk/tsa/downloads/ | |
| PubMed | National Library of Medicine | https://pubmed.ncbi.nlm.nih.gov/ | |
| Cochrane Library | Cochrane Library | https://www.cochranelibrary.com/ | |
| Embase | Elsevier | https://www.embase.com/search/quick | |
| SinoMed | SinoMed | http://www.sinomed.ac.cn/index.jsp | |
| CNKI | China National Knowledge Infrastructure | https://www.cnki.net/ | |
| VIP | Chongqing VIP Information Co., Ltd. | http://www.cqvip.com/ | |
| WanFang database | Wanfang Data Knowledge Service Platform | https://www.wanfangdata.com.cn/index.html |
References
- Bohmwald, K., et al. The causes and long-term consequences of viral encephalitis. Front Cellular Neurosci. 15, 755875(2021).
- Venkatesan, A., et al. Case definitions, diagnostic algori....
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