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OBJECTIVE:To evaluate the effectiveness and safety of Shenmai injection for shock.METHODS:Randomized controlled trials (RCTs) that evaluated the therapeutic effect of Shenmai injection on shock (including septic shock,cardiogenic shock,hypovolemic shock,neurogenic shock and anaphylactic shock) were included in this analysis.The major electronic databases were searched until May 2015.The methodological quality of the trials was assessed according to the Cochrane Handbook.Review Manager 5.3 and Stata 12.0 software were applied for data analysis.RESULTS:Thirty RCTs involving 2038 participants were included.The methodological quality of the trials was generally passable.The combined use of Shenmai injection and conventional medicine was significantly more effective at managing shock compared to conventional medicine alone in the outcomes of total effective rate [risk ratio (RR) 1.25,95％ confidence interval (C/) 1.18 to 1.31] and mortality rate [risk difference (RD)-0.10,95％ C/-0.17 to-0.02].Likewise,improvements were observed in other metrics.Three trials reported adverse events,but no trial reported serious adverse effects.CONCLUSION:Our results indicated the potential effectiveness of Shenmai injection combined with conventional medicine treatment for shock.However,further rigorously designed trials are needed to collect and weigh up all the evidence for the use of Shenmai injection.