TABLE 4.
Quality of evidence in the included studies assessed by GRADE.
| Author | Outcomes (participants) | Certainty assessment | Effect estimate (95% CI) | p Value | Quality of evidence | ||||
|---|---|---|---|---|---|---|---|---|---|
| Risk of bias | Inconsistency | Indirectness | Imprecision | Publication bias | |||||
| Chen et al. (2021a) | Total effectiveness rate (1882) | Serious a | Not serious | Not serious | Not serious | Not serious | RR 1.16 (1.12, 1.20) | <0.00001 | Moderate |
| Time until relief of abdominal pain (1,093) | Serious a | Serious b | Not serious | Not serious | Not serious | MD −1.74 (−1.96, −1.52) | <0.00001 | Low | |
| Time until relief of abdominal distension (637) | Serious a | Serious b | Not serious | Not serious | Not serious | MD −1.56 (−2.07, −1.04) | <0.00001 | Low | |
| Serum amylase level (508) | Serious a | Serious b | Not serious | Not serious | Not serious | MD −105.61 (−173.77, −37.46) | 0.002 | Low | |
| White blood cell recovery time (586) | Serious a | Serious b | Not serious | Not serious | Not serious | MD −1.51 (−1.66, −1.36) | <0.00001 | Low | |
| IL—6 level (984) | Serious a | Serious b | Not serious | Not serious | Not serious | MD -18.22 (-23.36, -13.08) | <0.00001 | Low | |
| CRP (560) | Serious a | Serious b | Not serious | Not serious | Not serious | MD −11.05 (−14.32, −7.78) | <0.00001 | Low | |
| Xu et al. (2021) | Total effectiveness rate (3,297) | Serious a | Not serious | Not serious | Not serious | Serious d | RR 1.20 (1.17, 1.24) | <0.00001 | Very low |
| Time until relief of abdominal pain (2,312) | Serious a | Serious b | Not serious | Not serious | Serious d | MD −1.64 (−1.87, −1.40) | <0.00001 | Very low | |
| Time until relief of abdominal distension (1,600) | Serious a | Serious b | Not serious | Not serious | Serious d | MD −1.48 (−1.78, −1.18) | <0.00001 | Very low | |
| Serum amylase level (1,084) | Serious a | Serious b | Not serious | Not serious | Serious d | MD −112.45 (−152.24, −72.67) | <0.00001 | Very low | |
| White blood cell recovery time (931) | Serious a | Serious b | Not serious | Not serious | Serious d | MD −2.44 (−3.13, −1.76) | <0.00001 | Very low | |
| Hospital stays (569) | Serious a | Serious b | Not serious | Not serious | Serious d | MD −4.84 (−6.78, −2.90) | <0.00001 | Very low | |
| IL—6 level (2,383) | Serious a | Serious b | Not serious | Not serious | Serious d | SMD −2.11 (−2.54, −1.69) | <0.00001 | Very low | |
| IL—8 level (1,162) | Serious a | Serious b | Not serious | Not serious | Serious d | SMD −1.98 (−2.57, −1.40) | <0.00001 | Very low | |
| TNF-α level (2,783) | Serious a | Serious b | Not serious | Not serious | Serious d | SMD −2.06 (−2.43, −1.68) | <0.00001 | Very low | |
| CRP (2,594) | Serious a | Serious b | Not serious | Not serious | Serious d | MD −2.12 (−2.51, −1.72) | <0.00001 | Very low | |
| Zhou et al. (2021) | Total effectiveness rate (364) | Serious a | Not serious | Not serious | Not serious | Serious d | RR 1.19 (1.09, 1.29) | <0.0001 | Low |
| Time until relief of abdominal pain (411) | Serious a | Not serious | Not serious | Not serious | Serious d | MD −1.65 (−2.03, −1.27) | <0.00001 | Low | |
| Time until relief of abdominal distension (316) | Serious a | Not serious | Not serious | Not serious | Serious d | MD −1.29 (−1.75, −0.82) | <0.00001 | Low | |
| Serum amylase level (411) | Serious a | Not serious | Not serious | Not serious | Serious d | MD −1.58 (−2.32, −0.84) | <0.0001 | Low | |
| White blood cell recovery time (411) | Serious a | Not serious | Not serious | Not serious | Serious d | MD −2.62 (−3.08, −2.16) | <0.00001 | Low | |
| TNF-α level (522) | Serious a | Not serious | Not serious | Not serious | Not serious | SMD −2.02 (−2.61, −1.43) | <0.00001 | Moderate | |
| IL-6 level (584) | Serious a | Not serious | Not serious | Not serious | Not serious | SMD −1.59 (−2.11, −1.06) | <0.00001 | Moderate | |
| Ma et al. (2017) | Total effectiveness rate (326) | Serious a | Not serious | Not serious | Not serious | Serious d | RR 1.16 (1.07, 1.25) | 0.0002 | Low |
| Time until relief of abdominal pain (813) | Serious a | Serious b | Not serious | Not serious | Not serious | MD −1.71 (−2.21, −1.21) | <0.01 | Low | |
| Serum amylase level (813) | Serious a | Serious b | Not serious | Not serious | Not serious | MD −1.82 (−2.39, −1.25) | <0.01 | Low | |
| White blood cell recovery time (553) | Serious a | Not serious | Not serious | Not serious | Not serious | MD −2.75 (−3.19, −2.31) | <0.01 | Moderate | |
| Hospital stays (55) | Serious a | Serious b | Not serious | Not serious | Not serious | MD −5.99 (−7.73, −4.26) | <0.01 | Low | |
| IL-6 level (226) | Serious a | Serious b | Not serious | Not serious | Serious d | SMD −1.09 (−2.66, 0.48) | <0.01 | Very low | |
| IL-8 level (212) | Serious a | Serious b | Not serious | Not serious | Serious d | SMD −1.02 (−1.66, −0.38) | <0.01 | Very low | |
| TNF-α level (226) | Serious a | Serious b | Not serious | Not serious | Serious d | SMD −1.10 (−1.68, −0.53) | <0.01 | Very low | |
| Zhang and Ke. (2016) | IL-6 level (616) | Serious a | Serious b | Not serious | Not serious | Not serious | SMD 1.86 (1.46, 2.27) | <0.001 | Low |
| IL-8 level (397) | Serious a | Serious b | Not serious | Not serious | Serious d | SMD 2.16 (1.45, 2.88) | <0.001 | Very low | |
| TNF-α level (760) | Serious a | Serious b | Not serious | Not serious | Not serious | SMD 2.16 (1.56, 2.76) | <0.001 | Low | |
| Zheng et al. (2015) | Total effectiveness rate (585) | Serious a | Not serious | Not serious | Not serious | Not serious | RR 0.85 (0.80, 0.91) | <0.00001 | Moderate |
| Hospital stays (280) | Serious a | Serious b | Not serious | Not serious | Serious d | MD −5.28 (−6.69, −3.86) | <0.00001 | Very low | |
| Ren et al. (2014) | Total effectiveness rate (326) | Serious a | Not serious | Not serious | Not serious | Serious d | RR 1.16 (1.07, 1.25) | 0.0002 | Low |
| Time until relief of abdominal pain (323) | Serious a | Serious b | Not serious | Not serious | Serious d | MD −1.86 (−2.27, −1.45) | <0.00001 | Very low | |
| Serum amylase level (421) | Serious a | Serious b | Not serious | Not serious | Serious d | MD −1.80 (−2.68, −0.93) | <0.00001 | Very low | |
| White blood cell recovery time (245) | Serious a | Serious b | Not serious | Not serious | Serious d | MD −2.49 (−3.56, −1.41) | <0.00001 | Very low | |
| Dond and Huang. (2011) | Time until relief of abdominal pain (513) | Serious a | Serious b | Not serious | Not serious | Not serious | MD −1.80 (−2.21, −1.38) | <0.00001 | Low |
| Serum amylase level (297) | Serious a | Serious b | Not serious | Not serious | Serious d | MD −2.61 (−3.01, −2.20) | <0.00001 | Very low | |
| Hospital stays (303) | Serious a | Serious b | Not serious | Serious c | Serious d | MD −4.66 (−7.02, −2.31) | <0.00001 | Very low | |
| Li et al. (2010) | Time until relief of abdominal pain (197) | Serious a | Not serious | Not serious | Not serious | Serious d | MD −1.91 (−2.19, −1.63) | <0.00001 | Low |
| Time until relief of abdominal distension (197) | Serious a | Not serious | Not serious | Not serious | Serious d | MD −1.88 (−2.33, −1.43) | <0.00001 | Low | |
| Serum amylase level (242) | Serious a | Not serious | Not serious | Not serious | Serious d | MD −2.58 (−3.02, −2.15) | <0.00001 | Low | |
| White blood cell recovery time (242) | Serious a | Not serious | Not serious | Not serious | Serious d | MD −1.78 (−2.24, −1.32) | <0.00001 | Low | |
GRADE, Grading of Recommendations Assessment, Development, and Evaluation.
a
The risk of bias is unclear in most of the studies.
b
The confidence interval overlap less, the heterogeneity test P was very small, and the I2 was larger (I2 threshold value: 50%).
c
The sample size is small, and the CI, is wide.
d
Funnel plot was not symmetrical, or the number of included studies was small and all were positive results (sample size threshold value: 500).