Comparative efficacy of traditional Chinese herbal injection for chronic renal failure:A systematic review and network meta-analysis of randomized controlled trials

摘要

Objective:To conduct a systematic review and network meta-analysis(NMA)for the comparison of the efficacy and safety of Chinese herbal injection(CHI)combined with Western medicine(WM)and WM monotherapy for chronic renal failure(CRF).Methods:Eight databases were searched from inception to August 30,2022.Randomized controlled trials(RCTs)regarding the comparison of CHI-WM combination therapy and WM monotherapy were included.Literature search,risk-of-bias assessment,and data extraction were conducted by 2 reviewers independently.NMA was performed by Stata 14.0,R 4.0.4 software,and the latest risk of bias assessment tool 2(RoB 2).Results:A total of 53 RCTs were finally included,involving 4445 participants and 16 CHIs.RoB 2 showed that 2 of these studies had a high risk of bias.Tianqi injection(TQ)t WM was the most effective in reducing serum creatinine(Scr)level.Xingding injection(XD)t WM was the most effective in reducing blood urea nitrogen(BUN)and cystatin C(Cys C)levels.Guhong injection(GH)t WM had the highest endogenous creatinine clearance rate(Ccr).Shuxuetong injection(SXT)t WM was the most effective in improving the clinical effective rate.Danhong injection(DH)t WM resulted in the lowest 24-h urinary protein quantity(24 h-UPQ),while Danshen injection(DS)t WM led to the lowest blood uric acid(UA)level.Shenfu injection(SF)t WM was the most effective in increasing hemoglobin(Hb)level.Conclusion:CHIs-WM combination therapy is more effective than WM monotherapy in treating CRF.Considering all of the indicators,SK t WM may be the optimal treatment option for improving renal function in patients with CRF.