Efficacy and safety of reduning injection for severe pneumonia: a systematic review and meta-analysis

ObjectivesReduning (RDN) injection is a traditional Chinese medicine (TCM) extract injection commonly used as an adjunct therapy for severe pneumonia (SP) in clinical practice in China; however, further validation is required. This study aims to systematically assess the efficacy and safety of RDN i...

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Main Authors: Yan Wang, Baichuan Xu, Peng Zhang, Suyun Li, Yang Xie
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Pharmacology
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Online Access:https://www.frontiersin.org/articles/10.3389/fphar.2025.1591136/full
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author Yan Wang
Yan Wang
Baichuan Xu
Baichuan Xu
Peng Zhang
Peng Zhang
Suyun Li
Suyun Li
Suyun Li
Yang Xie
Yang Xie
Yang Xie
author_facet Yan Wang
Yan Wang
Baichuan Xu
Baichuan Xu
Peng Zhang
Peng Zhang
Suyun Li
Suyun Li
Suyun Li
Yang Xie
Yang Xie
Yang Xie
author_sort Yan Wang
collection DOAJ
description ObjectivesReduning (RDN) injection is a traditional Chinese medicine (TCM) extract injection commonly used as an adjunct therapy for severe pneumonia (SP) in clinical practice in China; however, further validation is required. This study aims to systematically assess the efficacy and safety of RDN injection in treating SP.MethodsThe study was conducted using the data from CNKI, WanFang, VIP, SinoMed, PubMed, Embase, Cochrane Library, and Web of Science databases from their inception to 6 April 2024. We collected randomized controlled trials on the treatment of SP using RDN injection, and used Review Manager (version 5.3) for meta analysis. The primary outcomes was clinical efficacy. We used the Cochrane Risk of Bias Assessment Tool 2 (RoB 2) to assess the risk of bias for each study.ResultsA total of 1,897 patients with SP from 22 studies were included. The meta-analysis results showed that the combination of RDN injection and conventional treatment or antibiotic treatment for patients with SP was superior to traditional and antibiotic treatments alone in terms of clinical efficacy [risk ratio = 1.25%; 95% confidence interval (CI) (1.20, 1.30); p < 0.00001], fever reduction time [mean difference (MD) = −1.55 days; 95% CI (−1.91, −1.18); p < 0.00001], cough disappearance time [MD = −1.97 days; 95% CI (−2.63, −1.31); p < 0.00001], lung rales disappearance time [MD = −2.39 days; 95% CI (−3.09, −1.70); p < 0.00001], chest X-ray improvement time [MD = −2.73 days; 95% CI (−2.96, −2.49); p < 0.00001], and hospitalization time [MD = −3.11 days; 95% CI (−3.80, −2.41); p < 0.00001]. Moreover, no significant improvement was observed in the Acute Physiology and Chronic Health Evaluation II (APACHE II) scale compared to the control group [MD = −2.45 points; 95% CI (−6.07, 1.17); p = 0.19]. Lastly, not all studies reported any serious adverse events; however, some studies did report adverse reactions.ConclusionThe administration of RDN injection as an adjunct therapy for SP can enhance clinical efficacy, reduce fever duration, accelerate cough resolution, shorten the time for lung rales to resolve, accelerate chest X-ray improvement, and decrease hospitalization duration. Further well-designed and standardized large sample clinical studies are needed for validation.Systematic review registrationPROSPERO, identifier CRD42024540365.
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spelling doaj-art-c60c2a6594aa480d87cc068b1317d94f2025-08-20T03:40:50ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122025-08-011610.3389/fphar.2025.15911361591136Efficacy and safety of reduning injection for severe pneumonia: a systematic review and meta-analysisYan Wang0Yan Wang1Baichuan Xu2Baichuan Xu3Peng Zhang4Peng Zhang5Suyun Li6Suyun Li7Suyun Li8Yang Xie9Yang Xie10Yang Xie11National Regional Traditional Chinese Medicine (Lung Disease) Diagnosis and Treatment Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, ChinaThe First Clinical College of Henan University of Traditional Chinese Medicine, Zhengzhou, Henan, ChinaNational Regional Traditional Chinese Medicine (Lung Disease) Diagnosis and Treatment Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, ChinaThe First Clinical College of Henan University of Traditional Chinese Medicine, Zhengzhou, Henan, ChinaNational Regional Traditional Chinese Medicine (Lung Disease) Diagnosis and Treatment Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, ChinaThe First Clinical College of Henan University of Traditional Chinese Medicine, Zhengzhou, Henan, ChinaNational Regional Traditional Chinese Medicine (Lung Disease) Diagnosis and Treatment Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, ChinaCollaborative Innovation Center for Chinese Medicine and Respiratory Diseases Co-Constructed by Henan Province & Education Ministry of P.R. Zhengzhou, Zhengzhou, Henan, ChinaHenan Key Laboratory of Chinese Medicine for Respiratory Disease, Zhengzhou, Henan, ChinaNational Regional Traditional Chinese Medicine (Lung Disease) Diagnosis and Treatment Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, ChinaCollaborative Innovation Center for Chinese Medicine and Respiratory Diseases Co-Constructed by Henan Province & Education Ministry of P.R. Zhengzhou, Zhengzhou, Henan, ChinaHenan Key Laboratory of Chinese Medicine for Respiratory Disease, Zhengzhou, Henan, ChinaObjectivesReduning (RDN) injection is a traditional Chinese medicine (TCM) extract injection commonly used as an adjunct therapy for severe pneumonia (SP) in clinical practice in China; however, further validation is required. This study aims to systematically assess the efficacy and safety of RDN injection in treating SP.MethodsThe study was conducted using the data from CNKI, WanFang, VIP, SinoMed, PubMed, Embase, Cochrane Library, and Web of Science databases from their inception to 6 April 2024. We collected randomized controlled trials on the treatment of SP using RDN injection, and used Review Manager (version 5.3) for meta analysis. The primary outcomes was clinical efficacy. We used the Cochrane Risk of Bias Assessment Tool 2 (RoB 2) to assess the risk of bias for each study.ResultsA total of 1,897 patients with SP from 22 studies were included. The meta-analysis results showed that the combination of RDN injection and conventional treatment or antibiotic treatment for patients with SP was superior to traditional and antibiotic treatments alone in terms of clinical efficacy [risk ratio = 1.25%; 95% confidence interval (CI) (1.20, 1.30); p < 0.00001], fever reduction time [mean difference (MD) = −1.55 days; 95% CI (−1.91, −1.18); p < 0.00001], cough disappearance time [MD = −1.97 days; 95% CI (−2.63, −1.31); p < 0.00001], lung rales disappearance time [MD = −2.39 days; 95% CI (−3.09, −1.70); p < 0.00001], chest X-ray improvement time [MD = −2.73 days; 95% CI (−2.96, −2.49); p < 0.00001], and hospitalization time [MD = −3.11 days; 95% CI (−3.80, −2.41); p < 0.00001]. Moreover, no significant improvement was observed in the Acute Physiology and Chronic Health Evaluation II (APACHE II) scale compared to the control group [MD = −2.45 points; 95% CI (−6.07, 1.17); p = 0.19]. Lastly, not all studies reported any serious adverse events; however, some studies did report adverse reactions.ConclusionThe administration of RDN injection as an adjunct therapy for SP can enhance clinical efficacy, reduce fever duration, accelerate cough resolution, shorten the time for lung rales to resolve, accelerate chest X-ray improvement, and decrease hospitalization duration. Further well-designed and standardized large sample clinical studies are needed for validation.Systematic review registrationPROSPERO, identifier CRD42024540365.https://www.frontiersin.org/articles/10.3389/fphar.2025.1591136/fullreduning injectionsevere pneumoniameta-analysissystematic reviewrandomized controlled trial
spellingShingle Yan Wang
Yan Wang
Baichuan Xu
Baichuan Xu
Peng Zhang
Peng Zhang
Suyun Li
Suyun Li
Suyun Li
Yang Xie
Yang Xie
Yang Xie
Efficacy and safety of reduning injection for severe pneumonia: a systematic review and meta-analysis
Frontiers in Pharmacology
reduning injection
severe pneumonia
meta-analysis
systematic review
randomized controlled trial
title Efficacy and safety of reduning injection for severe pneumonia: a systematic review and meta-analysis
title_full Efficacy and safety of reduning injection for severe pneumonia: a systematic review and meta-analysis
title_fullStr Efficacy and safety of reduning injection for severe pneumonia: a systematic review and meta-analysis
title_full_unstemmed Efficacy and safety of reduning injection for severe pneumonia: a systematic review and meta-analysis
title_short Efficacy and safety of reduning injection for severe pneumonia: a systematic review and meta-analysis
title_sort efficacy and safety of reduning injection for severe pneumonia a systematic review and meta analysis
topic reduning injection
severe pneumonia
meta-analysis
systematic review
randomized controlled trial
url https://www.frontiersin.org/articles/10.3389/fphar.2025.1591136/full
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