Efficacy and safety of integration of traditional and Western medicine for the treatment of spontaneous bacterial peritonitis in liver cirrhosis: a systematic review

Integration of traditional and Western medicine (ITWM) has been widely used in China for the treatment of many diseases. ITWM may be a promising alternative for the treatment of spontaneous bacterial peritonitis (SBP). A systematic review was performed to evaluate the efficacy and safety of ITWM for the treatment of SBP in liver cirrhosis. PubMed, China National Knowledge Infrastructure, Wanfang, and VIP databases were searched electronically from inception to July 2016 to collect all randomized controlled trials (RCTs) about ITWM for the treatment of SBP in cirrhotic patients. A total of 42 RCTs were included. Rhubarb, Red Paeony Root, and Danshen Root were the three most commonly used traditional Chinese medicine (TCM) drugs; the third-generation cephalosporins were the most commonly used antibiotics. All included studies reported the effectiveness rate (ITWM group: 58.33–96.00%; control group: 32.20–93.75%); 41 studies showed a higher effectiveness rate in the ITWM group; and 38 studies found a significant difference. All included studies reported the cure rate (ITWM group: 9.00–95.00%; control group: 3.00–77.00%); 41 studies showed a higher cure rate in the ITWM group; and 10 studies found a significant difference. Four studies reported the mortality (ITWM group: 5.10–18.33%; control group: 7.69–52.78%) and showed a lower mortality in the ITWM group; and two studies found a significant difference. Six studies reported the adverse events (ITWM group: 0.00–13.33%; control group: 0.00–59.52%); five studies showed a lower rate of adverse events in the ITWM group; and four studies found a significant difference. ITWM might be effective and safe for the treatment of SBP. Further well-designed high-quality studies are needed to confirm the effectiveness and safety of ITWM for the treatment of SBP.