目的 运用网状Meta分析方法评价口服中成药联合常规治疗慢性肾衰竭的临床疗效及安全性。方法 计算机检索知网、万方、维普、中国生物医学文献服务系统、PubMed、EMbase、Cochrane Library等数据库中口服中成药治疗慢性肾衰竭的随机对照试验，检索时间为自建库至2021年5月1日。依据Cochrane偏倚风险评估对纳入文献进行质量评价，使用GeMTC软件、Stata 13.0进行分析。结果 最终纳入39个随机对照试验，6种中成药，样本量为3446例。网状Meta分析结果显示，在有效率方面，排名前3的中成药分别为百令胶囊+肾衰宁胶囊、肾衰宁胶囊、金水宝胶囊；在降低血肌酐方面，排名前3的中成药分别为百令胶囊+肾衰宁胶囊、海昆肾喜胶囊、尿毒清颗粒；在降低尿素氮方面，排名前3的中成药分别为百令胶囊+肾衰宁胶囊、海昆肾喜胶囊、尿毒清颗粒；在降低24 h尿蛋白定量方面，排名前3的中成药分别为黄葵胶囊+肾衰宁胶囊、百令胶囊+肾衰宁胶囊、黄葵胶囊。结论 口服中成药联合常规治疗可提高慢性肾衰竭的临床疗效，且安全性良好，其中百令胶囊+肾衰宁胶囊在所有疗效指标中均排名靠前，具有良好的临床应用价值。但受到研究质量及数量限制，仍需要大样本量、多中心、高质量随机对照试验对结果进一步验证。

Objective To evaluate the clinical efficacy and safety of oral Chinese patent medicine combined with routine therapy in the treatment of chronic renal failure by network Meta-analysis.Methods Randomized controlled trials of oral Chinese patent medicines in the treatment of chronic renal failure were searched from CNKI, Wanfang, VIP, Chinese Biomedical Literature Service, PubMed, EMbase, Cochrane Library and other databases, and the search time was from self-built database to May 1, 2021. The quality of the included literatures were evaluated according to the Cochrane bias risk assessment, and GeMTC software and Stata13.0 were used for analysis. Results Thirty-nine randomized controlled trials were included, including six kinds of Chinese patent medicines, with a sample size of 3446 cases. The results of network Meta-analysis showed that in terms of effective rate, the top three Chinese patent drugs were Bailing Capsule (百令胶囊) + Shenshuaining Capsule (肾衰宁胶囊), Shenshuaining Capsule and Jinshuibao Capsule (金水宝胶囊); In terms of reducing serum creatinine, the top three Chinese patent drugs were Bailing Capsule + Shenshuaining Capsule, Haikun Shenxi Capsule (海昆肾喜胶囊) and Niaoduqing Granules (尿毒清颗粒); In terms of reducing urea nitrogen, the top three Chinese patent drugs were Bailing Capsule + Shenshuaining Capsule, Haikun shenxi Capsule, Niaoduqing Granules; In terms of reducing the quantity of 24 h urine protein, the top three Chinese patent drugs were Huangkui Capsule (黄葵胶囊) + Shenshuaining Capsule, Bailing Capsule + Shenshuaining Capsule and Huangkui Capsule. Conclusion Oral Chinese patent medicine combined with routine treatment can improve the clinical efficacy of chronic renal failure, and the safety is good, among which Bailing Capsule + Shenshuaining Capsule ranked first in all the efficacy indicators, with good clinical application value. However, due to the limitations of study quality and quantity, large sample size, multi-center and high-quality randomized controlled trials are still needed to further verify the results.

R285.64

河南省中医管理局科研专项课题（2018JDZX016）