Objective  To systematically review the efficacy and safety of different oral Chinese patent medicines combined with conventional western medicines in the therapy of lumbar disc herniation (LDH).

Methods  PubMed, Embase, Cochrane Library, Medline, CNKI, WanFang data, VIP and SinoMed databases were electronically searched to collect randomized clinical trials (RCTs) on oral Chinese patent medicines combined with conventional western medicines in the treatment of LDH from the inception to April 10, 2023. Two reviewers independently screened the literature, extracted data, and evaluated the risk of bias of included studies. Network Meta-analysis was then performed by Stata 17.0 and RevMan 5.4 softwares.

Results  A total of 26 RCTs were included, involving 16 Chinese patent medicines with a total sample size of 2 448 cases. The network Meta-analysis results showed that 13 Chinese patent medicines combined with conventional western medicines had better effects than conventional western medicines alone. Among them, in terms of a better VAS score, the top three interventions were Jingyaokang capsules+ conventional western medicine>Yaobitong capsules+conventional western medicine>Huoxue Zhitong capsules+conventional western medicine; in terms of a better Japanese Orthopaedic Associationl (JOA) score, the top three interventions were Qufeng Zhitong capsules+conventional western medicine>Yaobitong capsules+conventional western medicine>Luchuan Huoluo capsules+conventional western medicine; in terms of the clinical effective rate, the top three interventions were Luchuan Huoluo capsules+conventional western medicine>Xianling Gubao capsules+conventional western medicine>Tongzhi Surunjiang capsules+conventional western medicine; in terms of safety, no serious adverse drug reactions occurred in all studies, and the overall incidence of adverse drug reactions in the oral Chinese patent medicines combined with conventional western medicines group was lower than that in the conventional western medicines group.

Conclusion  The combination of oral Chinese patent medicines and conventional western medicines has been shown to improve the clinical efficacy of LDH. Among these, Yaobitong capsules stand out for its ability to reduce VAS score, improve JOA score ranking, and increase the effective rate. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusions.

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