Objective  To systematically review the efficacy and safety of traditional Chinese patent medicines for tonifying lung and kidney combined with conventional Western medicine in the treatment of stable chronic obstructive pulmonary disease (COPD) by network Meta-analysis.

Methods  PubMed, Embase, Web of Science, Cochrane Library, CNKI, WanFang Data, VIP and SinoMed databases were electronically searched to collect randomized controlled trials (RCTs) of traditional Chinese patent medicines for tonifying lung and kidney to intervene in the stable phase of COPD from inception to June 25, 2024. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias in the included studies. Meta-analysis was performed by using RevMan 5.4 software. The network Meta-analysis was then performed using Stata 15.0 software.

Results  A total of 74 studies were included, involving 7 kinds of traditional Chinese patent medicines and 3 738 patients. The results of direct Meta-analysis showed that Chinese patent medicines combined with conventional Western medicine were superior to conventional Western medicine (P<0.001). The network Meta-analysis results showed that, Huanglong Kechuan capsules combined with conventional Western medicine had the best effect in improving the overall clinical efficacy. Heche Dazao capsules combined with conventional Western medicine had the best effect in improving FEV1. Yifei capsules combined with conventional Western medicine had the best effect in improving FVC. Jinshuibao capsules combined with conventional Western medicine had the best effect in improving FEV1/FVC. Jinshuibao capsules combined with conventional Western medicine had the best effect in increasing 6MWD. Yifei capsules combined with conventional Western medicine had the best effect in reducing COPD scores. Compared with conventional Western medicine, traditional Chinese patent medicines for tonifying lung and kidney combined with conventional Western medicine did not increase the occurrence of adverse drug reactions.

Conclusion  Different traditional Chinese patent medicines for tonifying the lung and kidney combined with conventional Western medicine have their advantages in the intervention of COPD in the stable stage, and have a better safety profile. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.

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