Objective: To systcmatically evaluate the effectiveness and safety of recombinant
human growth hormone (rhGH) in treating adults with severe
burn. Methods: Databases including PubMed, Cochrane Library, and Embase were searched using key words "
burns, thermal,
human growth hormone,
growth hormone, hGH, and
somatropin (human)" , and China Biology Medicine disc, Chinese Journals Full-text Database, VIP Database, and Wanfang Database were searched using key words in Chinese version "," to obtain the randomized controlled trials about rhGH in the treatment of adults with severe
burn from the establishment of each database to December 2016. The measurement indexes included
hemoglobin (Hb) and plasma total
protein, inflammatory factors [including
interleukin-6 (IL-6) and
tumor necrosis factor-α (TNF-α)], incidence rate of
sepsis, incidence rate of
hyperglycemia, wound healing time,
length of stay, and mortality rate. Meta-analysis was conducted by RevMan 5.3 statistical software. Results: A total of 8 trials involving 534 patients were included; 276 patients in rhGH group were treated with rhGH and 258 patients in placebo control group were treated with placebo. One trial had low risk of bias, while the other 7 trials had unclear risk of bias. The levels of Hb and plasma total
protein of patients in rhGH group were higher than those in placebo control group, with standardized mean differences (SMDs) respectively 2.00 and 2.23 [with 95% confidence intervals (CIs) respectively 0.19-3.82 and 1.21-3.26, P<0.05 or P<0.01]. The levels of
IL-6 and TNF-α of patients in rhGH group were lower than those in placebo control group, with SMDs respectively -1.46 and -1.13 (with 95% CIs respectively -2.40--0.53 and -1.75--0.51, P values below 0.05). Incidence rate of
sepsis and mortality rate of patients in rhGH group were lower than those in placebo control group, with relative risks (RRs) respectively 0.60 and 0.35 (with 95% CIs respectively 0.42-0.85 and 0.15-0.83, P values below 0.05). Incidence rate of
hyperglycemia of patients in rhGH group was higher than that in placebo control group, with RR of 2.39 (with 95% CI 1.79-3.18, P<0.001). The wound healing time and
length of stay of patients in rhGH group were lower than those in control group, with SMDs respectively -1.54 and -2.00 (with 95% CIs respectively -2.22--0.86 and -3.51--0.49, P<0.05 or P<0.01). Hb, plasma total
protein, inflammatory factors, incidence rate of
sepsis, wound healing time,
length of stay, and mortality rate showed no significant publication bias (P values above 0.05), while there may be publication bias in incidence rate of
hyperglycemia (P=0.026). Conclusions: rhGH can inhibit the breakdown of Hb and plasma total
protein, reduce the level of inflammatory factors and incidence rate of
sepsis, thus shorten the wound healing time and
length of stay, thereby reduce mortality rate of adult patients with severe
burn. However rhGH may cause
hyperglycemia.