The efficacy of Yunnan Baiyao on haemostasis and antiulcer: a systematic review and meta-analysis of randomized controlled trials.

Yunnan Baiyao (YNBY) is widely used to treat rhexis haemorrhage and ulcer in China. This meta-analysis was conducted to determine the efficacy of YNBY on local haemostasis and antiulcer. Randomized controlled trials were included on condition that assessing the effects of YNBY with/without routine drugs versus the same routine drugs on haemorrhage or ulcer after searching major databases. Data were validated, extracted and synthesized using relative risk (RR) for dichotomous data using random effects models. Fifty-five studies involving 5,150 patients were identified. (1) YNBY alone for haemorrhage (RR = 1.16; 95% CI 1.06 to 1.28) (2) YNBY alone for antiulcer (RR = 1.26; 95% CI 1.03 to 1.53). We found certain effects on ulcerative colitis (RR = 1.22) and skin ulcer (RR = 1.20) in subgroup analysis. (3) YNBY plus routine haemostatic drugs for haemorrhage (RR = 1.23; 95% CI 1.17 to 1.29) with a significant funnel plot asymmetry (Begg's test, p = 0). (4) YNBY plus routine antiulcer drugs for antiulcer (RR = 1.18; 95% CI 1.05 to 1.33). Treatment effect in the 2(nd) and 4(th) group was unstable when RCTs at high risk of bias were excluded. Great heterogeneities and possible publication bias were found among the trials which preclude certain conclusions. The existing data showed that YNBY alone was helpful in treating uterine haemorrhage, ulcerative colitis and skin ulcer. YNBY plus routine antiulcer drugs was more effective in treating ulcerative colitis versus antiulcer drugs alone.

[1]  S. Pak,et al.  Effects of cosmetics containing purified honeybee (Apis mellifera L.) venom on acne vulgaris. , 2013, Journal of integrative medicine.

[2]  S. Schulman Pharmacologic tools to reduce bleeding in surgery. , 2012, Hematology. American Society of Hematology. Education Program.

[3]  K. Kelly,et al.  Topical Yunnan Baiyao administration as an adjunctive therapy for bleeding complications in adolescents with advanced cancer , 2012, Supportive Care in Cancer.

[4]  Xin Li,et al.  Characteristics and Clinical Managements of Chronic Skin Ulcers Based on Traditional Chinese Medicine , 2012, Evidence-based complementary and alternative medicine : eCAM.

[5]  Guowang Xu,et al.  Therapeutic effect of Yunnan Baiyao on rheumatoid arthritis was partially due to regulating arachidonic acid metabolism in osteoblasts. , 2012, Journal of pharmaceutical and biomedical analysis.

[6]  Hynek Pikhart,et al.  Methods to decrease blood loss and transfusion requirements for liver transplantation. , 2011, Cochrane Database of Systematic Reviews.

[7]  Guanjian Liu,et al.  Quality assessment of reporting of randomization, allocation concealment, and blinding in traditional chinese medicine RCTs: A review of 3159 RCTs identified from 260 systematic reviews , 2011, Trials.

[8]  G. Guyatt,et al.  The importance of early treatment with tranexamic acid in bleeding trauma patients: an exploratory analysis of the CRASH-2 randomised controlled trial , 2011, The Lancet.

[9]  J. Vincent,et al.  Management of bleeding following major trauma: an updated European guideline , 2010, Critical care.

[10]  D. Moher,et al.  CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials , 2010, Journal of clinical epidemiology.

[11]  T. Kovacs,et al.  Gastric acid inhibition in the treatment of peptic ulcer hemorrhage , 2009, Current gastroenterology reports.

[12]  C. Liang,et al.  Effects of the preoperative administration of Yunnan Baiyao capsules on intraoperative blood loss in bimaxillary orthognathic surgery: a prospective, randomized, double-blind, placebo-controlled study. , 2009, International journal of oral and maxillofacial surgery.

[13]  Douglas G Altman,et al.  Empirical evidence of bias in treatment effect estimates in controlled trials with different interventions and outcomes: meta-epidemiological study , 2008, BMJ : British Medical Journal.

[14]  A. Rodgers,et al.  Randomized clinical trial of honey‐impregnated dressings for venous leg ulcers , 2007, The British journal of surgery.

[15]  H. Sumano,et al.  Successful Treatment of Canine Open Cervix–Pyometra with Yun-Nan-Pai-Yao, A Chinese Herbal Preparation , 2007, Veterinary Research Communications.

[16]  S. Sprague,et al.  Application of the Consort Statement to Randomized Controlled Trials Comparing Endoscopic and Open Carpal Tunnel Release , 2006, The Canadian journal of plastic surgery = Journal canadien de chirurgie plastique.

[17]  D. Altman,et al.  Outcome selection bias in meta-analysis , 2005, Statistical methods in medical research.

[18]  C. White,et al.  A Comparison of the Hemostatic Effects of Notoginseng and Yun Nan Bai Yao to Placebo Control , 2005, Journal of herbal pharmacotherapy.

[19]  Peter Jüni,et al.  Direction and impact of language bias in meta-analyses of controlled trials: empirical study. , 2002, International journal of epidemiology.

[20]  P. Molan The potential of honey to promote oral wellness. , 2001, General dentistry.

[21]  C. White,et al.  An Evaluation of the Hemostatic Effect of Externally Applied Notoginseng and Notoginseng Total Saponins , 2000, Journal of clinical pharmacology.

[22]  C. Begg,et al.  Operating characteristics of a rank correlation test for publication bias. , 1994, Biometrics.

[23]  N. Laird,et al.  Meta-analysis in clinical trials. , 1986, Controlled clinical trials.

[24]  Vipin Kumar,et al.  Gastric antisecretory and cytoprotective effects of hydroalcoholic extracts of Plumeria alba Linn. leaves in rats. , 2014, Journal of Integrative Medicine.

[25]  A. Marti-Carvajal,et al.  Antifibrinolytic amino acids for upper gastrointestinal bleeding in patients with acute or chronic liver disease. , 2012, Cochrane Database of Systematic Reviews.

[26]  P. Alex,et al.  An old herbal medicine with a potentially new therapeutic application in inflammatory bowel disease. , 2011, International journal of clinical and experimental medicine.

[27]  D. Moher,et al.  CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trials. , 2012, International journal of surgery.

[28]  G. Holle Pathophysiology and modern treatment of ulcer disease. , 2010, International journal of molecular medicine.

[29]  R. Peto,et al.  Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial. , 2010, Lancet.

[30]  V. Sharma,et al.  Proton pump inhibitor treatment for acute peptic ulcer bleeding. , 2006, Cochrane Database of Systematic Reviews.

[31]  M. Dören Hormonal replacement regimens and bleeding. , 2000, Maturitas.

[32]  Milicic Biljana,et al.  Bias in meta-analysis and funnel plot asymmetry , 1999, MIE.

[33]  P. Mannucci Hemostatic drugs. , 1998, The New England journal of medicine.

[34]  R. Xiu Microcirculation and traditional Chinese medicine. , 1988, JAMA.

[35]  T. Zhu [Progress in the pharmacological and clinical study of Yunnan baiyao]. , 1987, Zhong xi yi jie he za zhi = Chinese journal of modern developments in traditional medicine.