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) + WM was the most effective in reducing serum creatinine (Scr) level. Xingding injection (XD) + WM was the most effective in reducing blood urea nitrogen (BUN) and cystatin C (Cys C) levels. Guhong injection (GH) + WM had the highest endogenous creatinine clearance rate (Ccr). Shuxuetong injection (SXT) + WM was the most effective in improving the clinical effective rate. Danhong injection (DH) + WM resulted in the lowest 24-h urinary protein quantity (24 h-UPQ), while Danshen injection (DS) + WM led to the lowest blood uric acid (UA) level. Shenfu injection (SF) + 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 + WM may be the optimal treatment option for improving renal function in patients with CRF.
Scopus Subject Areas
- Complementary and alternative medicine
- Chinese herbal injections
- Chronic renal failure
- Combination therapy
- Network meta-analysis
- Systematic review