目的 基于网状Meta分析系统评价不同中药注射液治疗特发性间质性肺炎（idiopathic interstitial pneumonia，IIP）的有效性及安全性。方法 计算机检索中国知网、万方数据、维普、中国生物医学文献数据库、PubMed、Web of Science、Scopus、EMbase、Cochrane Library数据库的随机对照试验（randomized controlled trial，RCT），时间限定为建库至2024年1月31日，运用Review Manager 5.3、Stata 15进行数据分析。结果 最终纳入52项RCTs，涉及17种中药注射液，共计3 400例患者，其中试验组1 728例，对照组1 672例。网状Meta分析显示：①提高临床有效率方面，累积排序曲线下面积（surface under the cumulative ranking curve，SUCRA）排名前3的干预措施为丹红注射液＋西医常规、血必净注射液＋西医常规、苦参碱注射液＋西医常规；②增加用力肺活量（forced vital capacity，FVC）方面，SUCRA排名前3的干预措施为丹参川芎嗪注射液＋西医常规、丹红注射液＋西医常规、炎琥宁注射液＋西医常规；③提高第1秒用力呼气容积百分比（percentage of force expiratory volume in the first second，FEV1%）方面，SUCRA排名前3的干预措施为丹参川芎嗪注射液＋西医常规、丹红注射液＋西医常规、苦参碱注射液＋西医常规；④提高一氧化碳弥散量百分比（percentage of diffused carbon monoxide，DLCO%）方面，SUCRA排名前3的干预措施为参芎葡萄糖注射液＋西医常规、川芎嗪注射液＋西医常规、红景天注射液＋西医常规；⑤提高动脉氧分压（PaO₂）方面，SUCRA排名前3的干预措施为红花黄色素氯化钠注射液＋西医常规、红景天注射液＋西医常规、丹红注射液＋西医常规；⑥提高6 min步行试验（6 min walking test，6MWT）方面，SUCRA排名前3的干预措施为丹红注射液＋西医常规、痰热清注射液＋西医常规、参麦注射液＋西医常规；⑦降低转化生长因子-β1（transforming growth factor-β1，TGF-β1）方面，SUCRA排名前2的干预措施为丹红注射液＋西医常规、丹参川芎嗪注射液＋西医常规；⑧降低层黏连蛋白（laminin，LN）方面，SUCRA排名前2的干预措施为丹红注射液＋西医常规、川芎嗪注射液＋西医常规。结论 中药注射液联合西医常规治疗能够提高临床有效率，改善肺功能及动脉血气水平，提高运动耐量，改善肺纤维化。受纳入研究的研究质量限制，仍需要更多的大样本、多中心、高质量的RCT加以验证。

Objective To evaluate the efficacy and safety of different traditional Chinese medicine injections (TCMIs) in the treatment of idiopathic interstitial pneumonitis (IIP) based on network Meta-analysis. Methods The randomized controlled trials (RCTs) were retrieved from CNKI, Wanfang data, VIP, Chinese Biomedical Literature Database, PubMed, Web of Science, Scopus, Embase, and Cochrane Library databases, with a time limit of database establishment until January 31, 2024. Data analysis was conducted using Review Manager 5.3 and Stata 15. Results A total of 52 RCTs were included, involving 17 kinds of TCMIs, with a total sample size of 3 400 cases, including 1 728 cases in the experimental group and 1 672 cases in the control group. Network Meta-analysis revealed: ①In terms of improving clinical total effective rate, the top 3 interventions with surface under the cumulative ranking curve (SUCRA) were Danhong Injection (丹红注射液) + western medicine routine, Xuebijing Injection (血必净注射液) + western medicine routine, and Kushenjian Injection (苦参碱注射液) + western medicine routine; ②In terms of increasing forceful lung capacity (FVC), the top three interventions with SUCRA were Danshen Chuanxiongqing Injection (丹参川芎嗪注射液) + western medicine routine, Danghong Injection + western medicine routine, and Yanhuning Injection (炎琥宁注射液) + western medicine routine; ③In terms of increasing the percentage of force expiratory volume in the first second (FEV1%), the top three interventions with SUCRA were Dashen Chuanxiongqing Injection + western medicine routine, Danhong Injection + western medicine routine, and Kushenjian Injection + western medicine routine; ④In terms of increasing the percentage of diffused carbon monoxide (DLCO%), the top three interventions with SUCRA were Shenxiong Glucose Injection (参芎葡萄糖注射液) + western medicine routine, Chuanxiongqin Injection + western medicine routine, Hongjingtian Injection (红景天注射液) + western medicine routine; ⑤In terms of increasing the partial pressure of arterial oxygen (PaO₂), the top three interventions with SUCRA were Safflower Yellow Pigment Sodium Chloride Injection (红花黄色素氯化钠注射液) + western medicine routine, Hongjingtian Injection (红景天注射液) + western medicine routine, and Danghong Injection + western medicine routine; ⑥In terms of increasing the 6 minute walking test (6MWT), the top three interventions with SUCRA were Danhong Injection + western medicine routine, Tanreqing Injection (痰热清注射液) + western medicine routine, and Shenmai Injection (参麦注射液) + western medicine routine; ⑦In terms of reducing transfer growth factor-β1 (TGF-β1), the top two interventions with SUCRA were Danhong Injection + western medicine routine, and Danshen Chuanxiongqin Injection + western medicine routine; ⑧In terms of reducing laminin (LN), the top two interventions with SUCRA were Danhong Injection + western medicine routine, and Chuanxiongqin Injection + western medicine routine. Conclusion TCMI combined with Western medicine routine treatment can increase clinical efficiency, improve lung function and arterial blood gas level, improve exercise tolerance, and improve pulmonary fibrosis. Due to the quality limitations of the included studies, more large-sample, multicenter, high-quality RCTs are still needed for validation.

R285.64

国家自然科学基金青年科学基金项目（82004306）