OBJECTIVE  To systematically evaluate the efficacy and safety of Xijiao Dihuang decoction combined with western medicine in the treatment of anaphylactoid purpura.

  METHODS  A comprehensive search of PubMed, CBM, CNKI and other databases was conducted to collect randomized controlled trials of Xijiao Dihuang decoction combined with western medicine in the treatment of anaphylactoid purpura. The literature was screened, information extracted and quality evaluated according to inclusion and exclusion criteria. The outcome indicators were evaluated according to the GRADE evidence quality grading system, and the risk of bias was assessed and Meta-analysis was performed using RevMan5. 3 software.

  RESULTS  A total of 23 studies involving 1, 919 patients were included. Meta-analysis showed that compared with the simple western medicine treatment, the integrated Chinese and western medicine combined with Xijiao Dihuang decoction could improve the total effective rateRD=0.18, 95%CI(0.15, 0.21), P < 0.01, reduce the recurrence rate RD=-0.17, 95%CI(-0.334 5, -0.004 2), P < 0.05 and the adverse reaction rate RD=-0.05, 95%CI(-0.090 5, -0.004 7), P < 0.01. Besides, it could also reduce purpura regression time MD=-6.73, 95%CI(-10.58, -2.89), P < 0.01, rash regression time MD=-3.08, 95%CI(-4.25, -1.92), P < 0.01, gastrointestinal symptoms regression time MD=-3.49, 95%CI(-5.54, -1.43), P < 0.01, abdominal pain regression time MD=-1.97, 95%CI(-2.23, -1.71), P < 0.01, as well as joint swelling and pain regression time MD=-6.60, 95%CI(-8.88, -4.31), P < 0.01. The GRADE of outcome indicators included medium, low and extreme low levels.

  CONCLUSION  Xijiao Dihuang decoction combined with conventional western medicine can improve the total effective rate of anaphylactoid purpura. In addition, it can reduce the recurrence rate, and the regression time of all clinical symptoms without increasing the adverse reaction rate.