Objective  To compare the efficacy and safety of different Chinese patent medicines in the treatment of benign prostatic hyperplasia (BPH) by Bayesian network Meta-analysis.

Methods PubMed, EMbase, Cochrane Library, CNKI, SinoMed, WanFang Data and VIP databases were electronically searched to collect randomized controlled trials (RCTs) of Chinese patent medicine in the treatment of BPH from inception to January 1, 2023. Two researchers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Bayesian network Meta-analysis was performed using Stata 15.0 and GeMTC 14.3 software.

Results  A total of 51 RCTs involving 12 kinds of Chinese patent medicines and 4 927 patients were included. The results of direct Meta-analysis showed that Chinese patent medicine combined with conventional western medicine was superior to conventional western medicine alone in reducing international prostate symptom score (MD= -4.44, 95%CI -5.09 to -3.79, P﹤0.001), improving maximum urinary flow rate (MD=3.16, 95%CI 2.71 to 3.61, P﹤0.001), reducing residual urine volume (MD=-8.27, 95%CI -9.62 to -6.92, P﹤0.001) and prostate volume (MD=-3.89, 95%CI -4.60 to -3.18, P﹤0.001). The results of the network Meta-analysis showed that the Longbishu capsules combined with conventional western medicine had the best effect in reducing the international prostate symptom score. In terms of improving maximum urinary flow rate, Xialiqi capsules combined with conventional western medicine had the best effect. Zegui Longshuang capsules combined with conventional western medicine had the best effect in reducing residual urine volume. In terms of reducing prostate volume, Relinqing granules combined with conventional western medicine had the best effect. The incidence of adverse reactions in the Chinese patent medicine combined with conventional western medicine group (8.27%) was lower than that in the conventional western medicine group (11.98%).

Conclusion  The existing evidence shows that compared with conventional western medicine alone, Chinese patent medicine combined with conventional western medicine is better than conventional western medicine alone in improving various clinical symptoms of BPH, and has better safety. Various proprietary Chinese patent medicines have different therapeutic focuses, and individualized medication can be used according to the specific symptoms of BPH patients in clinical treatment. Limited by the quantity and quality of the included studies, the above conclusions need to be verified by more high-quality studies.

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