A Systematic Review of Rhubarb (a Traditional Chinese Medicine) Used for the Treatment of Experimental Sepsis

Table 3

Outcome index of included trials.

Included trials (years)	Outcome indexes (time), intergroup differences^▽
Zhao et al. (1992) [15]	ETX in blood (q12 h from 0 h to 48 h),
Chen et al. (1994) [16]	(1) Bacteria culture of swabs of liver, spleen, and mesentery (24 h) and LPO level of liver and small intestine (24 h),; (2) SOD content of liver, small intestine, and plasma (24 h),
Luo et al. (1996) [17]	(1) Survival rates (40 d); TG survival rates were higher, value NA; (2) HSV antigen in brain, heart, liver, and ganglion (the 2nd, 4th, 6th, 8th, 10th, 12th, 16th, 20th, 30th, and 40th days); TG HSV antigen titer was lower, value NA
Chen et al. (1997) [18]	Intestine ratio and IVP (4 h AMI),
Yang et al. (1998) [19]	MAP, of small intestine and ITPD (4 h AMI),
Yang et al. (1998) [20]	(1) MAP, plasma, and intestinal PLA2 level, intestinal PAF level (4 h AMI),; (2) Plasma PAF level (4 h AMI),
Li et al. (2000) [21]	(1) Lung ratio (2 h AMI),; (2) BALF neutrophil rate and protein content, LPI and PVP, plasma NO, and lung iNOs level (2 h AMI),
Li and Chen (2001) [22]	(1) Plasma TNF-α level (24 h ASP),; (2) TNFR1 and TNFR2 DNA expression of small intestine (24 h ASP), lower TNFR1 and TNFR2 expression in TG, value NA
Shu et al. (2003) [23]	(1) PVP and lung endotoxin level (0 h, 24 h, 48 h, 72 h, 96 h, and 120 h), (48 h, 72 h, 96 h, and 120 h); (2) Lung TNF-α level (0 h, 24 h, 48 h, 72 h, 96 h, and 120 h), (48 h, 72 h, 96 h, and 120 h); (3) Neutrophil percentage in BALF (0 h, 24 h, 48 h, 72 h, 96 h, and 120 h), lower percentages of neutrophils and macrophages in TG (48 h, 72 h, 96 h, and 120 h),
Chen (2003) [24]	(1) Liver TNF-α gene expression, TNF-α levels in plasma and liver and plasma IL-6 level (24 h ASP),; (2) Liver IL-1β gene expression (24 h ASP), no IL-1β gene expression in TG; (3) Plasma endotoxin level (24 h ASP),; (4) TNFR1 and TNFR2 DNA expression of liver (24 h ASP), lower TNFR1 and TNFR2 expression in TG, value NA; (5) Liver mitochondria cytochrome C ATP and EC levels (2 h, 4 h, and 8 h ALPSI),; (6) Liver mitochondria cytochrome oxidase level and SOD levels in plasma, small intestine, and liver (2 h, 4 h, and 8 h ALPSI),
Yin et al. (2003) [25]	Lung , BALF neutrophil percentage and BALF protein content; LPI and PVP; lung MDA, SOD, and MPO (the 16th day),
Zhang et al. (2007) [26]	IEC apoptosis; intestinal TNF-α mRNA expression, IL-10 mRNA expression, and ZO-1/occludin mRNA expression; intestinal MDA and SOD levels (NA),
Wu et al. (2007) [27]	Plasma TNF-α level, MV BFV, PLF protein/plasma protein level ratio, and pathological scores of intestinal mucosa (72 h),
Xing et al. (2009) [28]	(1) Plasma TNF-α level (0 h, 3 h, 8 h, 24 h, 48 h, and 72 h), (8 h); (2) Plasma HMGB1 level (0 h, 3 h, 8 h, 24 h, 48 h, and 72 h), (24 h, 48 h, and 72 h)
Chen et al. (2009) [29]	(1) Gut enteric bacilli count (the 1st, 3rd, and 9th days), (the 3rd and 9th days); (2) Bacteria species in gut (the 1st, 3rd, and 9th days), less colibacillus loss in TG, value NA; (3) Bacterial translocation (the 1st, 3rd, and 9th days), (the 1st day)
Han et al. (2011) [30]	(1) Plasma TNF-α and IL-8 level (24 h, 48 h, and 72 h),; (2) Pathological scores of intestinal mucosa (72 h),
Huang et al. (2012) [31]	(1) Gut Enterococcus count, lactobacilli count, and aerobe count (the 10th day),; (2) Gut Bifidobacterium count, Escherichia coli count, and anaerobe count; gut anaerobe to aerobe ratios (the 10th day),
Ma et al. (2012) [32]	(1) Gut enteric bacilli count (24 h),; (2) Gut lactobacilli count, colon content, gut monilia count, and species (24 h),
Ma et al. (2012) [33]	(1) Plasma endotoxin, TNF-α and IL-1β level; liver IL-10, MDA, and SOD level (8 h),
Li et al. (2013) [34]	(1) RBC velocity in MV (#), (from 50 to 90 min ALPSI); (2) WSR (#),; (3) Leukocyte rolling velocity in MV (#), pretreatment: (from 60 to 90 min ALPSI), posttreatment: (4) Cell count of rolling leukocytes along MV walls (#), pretreatment: (50 and 60 min ALPSI), posttreatment: (5) Leukocyte adhesion to MV walls (#), pretreatment: (from 20 to 90 min ALPSI), posttreatment: (6) Leukocyte emigration out of MV; DHR fluorescence intensity ratio on MV walls; albumin leakage from MV (#), (from 40 to 90 min ALPSI); (7) Mast cell degranulation, blood L-selectin, and CD11b (90 mins ALPSI), pretreatment: , posttreatment: (8) Blood CD18 (90 min ALPSI),; (9) TLR4, NF-κB p65, AP-1, MPO, and ICAM-1 expression in intestine (90 min ALPSI),
Li (2013) [35]	(1) Plasma DAO level (6 h, 12 h, 24 h, and 48 h), (versus NTG, 24 h and 48 h), (versus PCG); (2) Intestinal DAO level (48 h),; (3) Plasma TNF-α level (6 h, 12 h, 24 h, and 48 h), (versus NTG, 6 h), (versus NTG, 12 h), and (versus PCG)
Cui (2013) [36]	(1) Intestinal wall blood flow, lactate/pyruvate ratio in jejuna, the area of intestinal mucosa capillary, and intestinal mucosa capillary count (24 h AMI),; (2) Intestinal mucosa blood flow (24 h AMI),
Chen et al. (2013) [37]	(1) Lung ratio and plasma TNF-α and IL-1β level (6 h),; (2) Lung NF-κB p65 (6 h), lower NF-κB p65 expression in TG, value NA
Zhang et al. (2014) [38]	(1) Peripheral blood leucocyte and hepatocyte GR binding capacity (12 h, 24 h, and 72 h ALPSI),; (2) CD4+ lymphocytes in peripheral blood (12 h, 24 h, and 72 h ALPSI), (12 h and 24 h); (3) CD8+ lymphocytes in peripheral blood (12 h, 24 h, and 72 h ALPSI),; (4) CD4+/CD8+ ratio (12 h, 24 h, and 72 h ALPSI), (24 h and 72 h)
Su (2014) [39]	(1) Plasma IL-6 and IL-17 level (12 h ALPSI),; (2) Lung ratio; lung MDA, SOD, GSH-Px, and CAT level; lung pathological scores (12 h ALPSI),
Liu et al. (2014) [40]	(1) Lung ratio and LPI (3 h, 6 h, 12 h, and 24 h AMI), (12 h and 24 h); (2) Lung pathological scores (3 h, 6 h, 12 h, and 24 h AMI), (24 h)
Sun et al. (2014) [41]	(1) Lung AQP-1 mRNA expression (3 h, 6 h, 12 h, and 24 h AMI),; (2) Lung AQP-1 protein expression (3 h, 6 h, 12 h, and 24 h AMI), (6 h, 12 h, and 24 h AMI)

Note. ^▽P value of the comparison between treatment group and control group at each test time phase unless otherwise stated; according to Chiu’s method [42]; according to Hofbauer’s method [43]; 1 point for no injury, 2 points for 25% injuries, 3 points for 50%, 4 points for 75%, and 5 points for diffuse damage. #: every 10 min from 0 to 90 min ALPSI; ALPSI: after LPS injection; AMI: after model induction; AP-1: activator protein-1; AQP-1: aquaporin 1; ASP: after scald procedure; BFV: blood flow velocity; CAT: catalase; DAO: diamine oxidase; DHR: dihydrorhodamine; EC: energy charge; ETX: endotoxin concentration; GSH-Px: glutathione-peroxidase; GR: glucocorticoids receptor; ICAM: intercellular adhesion molecule; IEC: intestinal epithelial cells; ITPD: intestine transmural potential difference; IVP: intestinal vascular permeability, defined as the fluorescence protein content in intestinal tissue; TG: treatment group; LPI: lung permeability index, calculated by BALF protein to plasma protein ratio; LPO: lipid peroxides; MAP: mean arterial pressure; MDA: malondialdehyde; MPO: myeloperoxidase; MV: mesenteric venule; NA: not available; NTG: no treatment group; PAF: platelet activating factor; PCG: positive control group, the group animals that were treated with positive medicine; PLA₂: phospholipase A₂; PLF: peritoneal lavage fluid; PVP: pulmonary vascular permeability, defined as the Evans blue content in lung tissue; RBC: red blood cell; SOD: superoxide dismutase; TNF-α: tumor necrosis factor-α; : wet to dry weight ratio; WSR: wall shear rate.