Chinese herbal medicine Xingnaojing injection () for hypoxic ischemic encephalopathy in newborns: A systematic review and meta-analysis.

OBJECTIVES: To evaluate the effificacy and safety of Chinese herbal medicine Xingnaojing Injection () for newborns with hypoxic ischemic encephalopathy (HIE). METHODS: Literatures were identifified by searching the PubMed, EMBASE, Cochrane Library, Cochrane Central, and four Chinese literature databases from the establishment of database to October in 2013. Relevant reference lists were also screened. Two reviewers independently evaluated the methodological quality of included studies. We also conducted the meta-analysis. RESULTS: Thirteen trials involving 1,169 patients were included. There was no trial reported death or disability at the end of follow-up period. Meta-analysis of 4 trials (n=371) showed that there was no signifificant difference in the reduction of mortality [risk ratios (RR)=0.48, 95% confifidence intervals (CI, 0.21, 1.13), P=0.09] between the Xingnaojing and control groups. Meta-analysis of 5 trials (n=359) showed that there was significant difference in reducing the major neurodevelopmental disability [RR=0.36, 95% CI (0.19, 0.66), P=0.001]. Meta-analysis of 6 trials (n=447) showed that there was signifificant difference in the author selfdefifined symptom improvement [RR=1.25, 95% CI (1.14, 1.37), P<0.01]. No fatal side-effects were reported. CONCLUSION: Based on the limited evidence, the routine use of Xingnaojing Injection for treatment of HIE in newborns is not recommended. Further well-conducted trials are justifified.