Chinese Herbal Medicine Xingnaojing Injection (醒脑静注射液) for Hypoxic Ischemic Encephalopathy in Newborns: A Systematic Review and Meta-Analysis

Objectives To evaluate the efficacy and safety of Chinese herbal medicine Xingnaojing Injection (醒脑静注射液) for newborns with hypoxic ischemic encephalopathy (HIE). Methods Literatures were identified 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 significant difference in the reduction of mortality [risk ratios (RR)=0.48, 95% confidence 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 significant difference in the author self-defined symptom improvement [RR=1.25, 95% CI (1.14, 1.37), P