{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T13:44:33Z","timestamp":1785332673145,"version":"3.55.0"},"reference-count":58,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:00:00Z","timestamp":1761004800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Xuebijing injection is a standardized traditional Chinese medicine formulation comprising extracts from safflower, red peony, Chuanxiong, Angelica, and Salvia miltiorrhiza. It is clinically employed for the treatment of sepsis and associated complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This systematic review evaluated the efficacy and safety of Xuebijing injection in treating sepsis-associated acute kidney injury (SA-AKI). Six databases were searched up to 1 September 2024, to identify randomized controlled trials (RCTs) comparing Xuebijing injection combined with conventional therapies versus the same conventional therapies alone. Data from individual RCTs were synthesized by meta-analysis, with effect measures expressed as risk ratios (RRs) or mean differences (MDs) and their 95% confidence intervals (CIs). Trial sequential analysis was used to assess the precision of the effect estimates, and the GRADE system was used to evaluate the quality of evidence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighteen RCTs involving 1,650 patients were included. Meta-analysis demonstrated that, compared with conventional therapies alone, Xuebijing injection combined with conventional therapies significantly reduced 28-day mortality (RR 0.82%, 95% CI 0.69\u20130.98). It also significantly improved renal function (serum creatinine level: MD -17.55\u00a0\u03bcmol\/L, 95% CI: \u221223.22 to \u221211.88; blood urea nitrogen level: MD -1.58\u00a0mmol\/L, 95% CI -1.83 to \u22121.32; urine volume: MD 5.83\u00a0ml, 95% CI: 3.45\u20138.21), inflammatory cytokines (tumor necrosis factor-alpha level: MD -29.20\u00a0ng\/ml, 95% CI: \u221239.15 to \u221219.25; interleukin-6 level: MD -25.80\u00a0ng\/mL, 95% CI: \u221235.56 to \u221216.04; interleukin-10 level: MD -8.02\u00a0ng\/mL, 95% CI: \u221213.98 to 2.07), and immune function (percentage of CD3<jats:sup>+<\/jats:sup> T cells: MD 10.30%, 95% CI 7.77%\u201312.84%; percentage of CD3<jats:sup>+<\/jats:sup> T cells: MD 9.57%, 95% CI 3.53%\u201315.61%; CD4\/CD8 ratio: MD 0.27, 95% CI 0.18\u20130.36). In addition, Xuebijing injection significantly alleviated the severity of SA-AKI as measured by the Acute Physiology and Chronic Health Evaluation II score (MD -3.12, 95% CI: \u22124.51 to \u22121.73). Subgroup analyses suggested potential effect modifications based on treatment duration or dosage. All reported adverse reactions were mild.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Xuebijing injection may help reduce mortality and improve renal function in patients with SA-AKI. However, the certainty of evidence ranged from moderate to very low, underscoring the need for validation through large-scale, double-blind randomized controlled trials.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fphar.2025.1643557","type":"journal-article","created":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T05:36:51Z","timestamp":1761025011000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Comparative efficacy and safety of Xuebijing injection as adjuvant therapy in sepsis-associated acute kidney injury: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"16","author":[{"given":"Bofei","family":"Shu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xu","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Fan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Can","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Deng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bangjiang","family":"Fang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1016\/j.jclinepi.2010.07.015","article-title":"GRADE guidelines: 3. 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