Journal of Traditional Chinese Medicine ›› 2024, Vol. 44 ›› Issue (6): 1067-1081.DOI: 10.19852/j.cnki.jtcm.20240927.002
• Meta-Analyses • Next Articles
Network Meta-analysis of the clinical efficacy and safety of kidney-tonifying and bone-strengthening therapies for the treatment of rheumatoid arthritis with kidney deficiency type
GAN Chang1,2,3, TAO Qingwen2,3, YI Haoying1,2,3, BIAN Yuting1,2,3, WANG Jianming2,3(
)
- 1 School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China
2 Department of Traditional Chinese Medicine Rheumatology, China-Japan Friendship Hospital, Beijing 100029, China
3 Beijing Key Lab for Immune-Mediated Inflammatory Diseases, China-Japan Friendship Hospital, Beijing 100029, China
-
Received:2023-09-10Accepted:2023-12-22Online:2024-12-15Published:2024-09-27 -
Contact:Prof. WANG Jianming, Department of Traditional Chinese Medicine Rheumatology, China-Japan Friendship Hospital, Beijing 100029, China. wangjianming@zryhyy.com.cn Telephone: +86-13910890713 -
Supported by:National Natural Science Foundation of China: Therapy which Invigorating Kidney and Strengthening Bone Regulates the Balance between Osteoblast and Osteoclast in Treating Rheumatoid Arthritis Bone Destruction: a Mechanism Study(82074223);National Natural Science Foundation of China: Therapy which Invigorating Kidney and Strengthening Bone Regulates the Balance between Osteoblast and Osteoclast in Treating Rheumatoid Arthritis Bone Destruction: a Mechanism Study(82274435);Fifth Batch of National Training Program for Clinical Excellence in Chinese Medicine(2022178)
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GAN Chang, TAO Qingwen, YI Haoying, BIAN Yuting, WANG Jianming. Network Meta-analysis of the clinical efficacy and safety of kidney-tonifying and bone-strengthening therapies for the treatment of rheumatoid arthritis with kidney deficiency type[J]. Journal of Traditional Chinese Medicine, 2024, 44(6): 1067-1081.
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Table 1 Basic characteristics of the included literature
| Included study | Cases (male/female, n) | Age (years) | Duration of illness (years) | Intervention | Treatment duration (weeks) | Outcome indicator | ||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| T | C | T | C | T | C | T | C | |||||||||||||||||||||
| Chen D et al 2018 | 9/16 | 8/17 | 34.4± 15.54 | 34.45±15.85 | 6.75±3.97 | 6.67±3.62 | Bushen Quhan Zhiwang decoction + Methotrexate | Methotrexate | 24 | ①② | ||||||||||||||||||
| Chen F et al 2016 | 11/24 | 13/22 | 37.52± 6.61 | 37.34±6.48 | 2.2±0.51 | 2.1±0.37 | YJC+Methotrexate+Leflunomide+Celecoxib | Methotrexate+Leflunomide+Celecoxib | 8 | ①②③④ | ||||||||||||||||||
| Chen L et al 2021 | 31/144 | 33/142 | 47.28± 12.19 | 49.11±11.62 | ≤1 | WT+Methotrexate+Acetaminophen | Methotrexate+WT analog+Acetaminophen | 12 | ② | |||||||||||||||||||
| Chen XL et al 2020 | 7/23 | 8/22 | 41.6±5.2 | 42.8± 4.7 | 3.2 | 3.3 | DJD+Leflunomide | Leflunomide | 8 | ④ | ||||||||||||||||||
| Chen YG et al 2019 | 2/23 | 4/21 | 51.4±5.8 | 53.6± 8.6 | 8.0±3.9 | 7.9±4.1 | DJD+Methotrexate+Leflunomide+Meloxicam | Methotrexate+Leflunomide+Meloxicam | 12 | ①②③④ | ||||||||||||||||||
| Du DY et al 2019 | 16/32 | 18/30 | 44.75± 6.73 | 44.80±6.69 | 4.24±1.61 | 4.24±1.61 | DJD+Methotrexate+Meloxicam | Methotrexate+meloxicam | 4 | ①②③④ | ||||||||||||||||||
| Gao Y et al 2015 | 14/46 | 15/45 | 64.0±3.2 | <1 | YJC+Methotrexate+Etoricoxib | Methotrexate+Etoricoxib | 12 | ②③④ | ||||||||||||||||||||
| He CX et al 2018 | - | - | 49.77± 11.43 | 49.74±11.59 | 7.13±6.74 | 6.8±6.04 | Bushen Quhan Zhiwang decoction+Methotrexate | Methotrexate | 12 | ①②③④ | ||||||||||||||||||
| He YK et al 2015 | 3/26 | 4/23 | 42.86± 9.54 | 47.26±13.56 | 11.34±7.35 | 12.04±7.88 | BJTF+Methotrexate | Methotrexate | 12 | ② | ||||||||||||||||||
| He YK et al 2018 | 9/29 | 12/28 | 48.14± 10.24 | 49.59±11.78 | 10.51±6.98 | 11.01±6.58 | BJTF+Methotrexate | Methotrexate | 24 | ①③④ | ||||||||||||||||||
| Hou HL et al 2013 | 6/24 | 7/23 | 52.63± 11.57 | 51.86±11.09 | 3.90±3.14 | 5.01±4.54 | WP+Methotrexate+Meloxicam | Methotrexate+Meloxicam | 4 | ①③④ | ||||||||||||||||||
| Ji HW et al 2012 | - | - | 26-64 | 0.25~20 | WT+Methotrexate | Methotrexate | 8 | ①②③④ | ||||||||||||||||||||
| Li N et al 2014 | 14/36 | 12/38 | 46.5±5.1 | 46.1± 4.8 | 5.2±2.3 | 5.4±2.2 | Bushen Quhan Zhiwang decoction+Methotrexate | Methotrexate | 20 | ①② | ||||||||||||||||||
| Li SQ et al 2017 | 15/28 | 13/30 | 43.2±6.3 | 41.7± 6.3 | 4.1±2.8 | 4.9±2.7 | Bushen Quhan Zhiwang decoction+Methotrexate | Methotrexate | 20 | ①② | ||||||||||||||||||
| Li XL et al 2015 | 10/24 | 11/23 | 43.5±7.2 | 44.7± 7.2 | 7.2±2.1 | 7.14±2.2 | QTOL+Methotrexate | Methotrexate | 8 | ①③④ | ||||||||||||||||||
| Liang J et al 2015 | 6/28 | 9/19 | 35.2± 13.6 | 36.1± 12.2 | 1.4±0.6 | 1.3±0.5 | Bushen Quhan Zhiwang decoction+Methotrexate | Methotrexate | 3 | ①②③④ | ||||||||||||||||||
| Lin GY et al 2016 | 42/33 | 40/35 | 47.4±4.2 | 46.4± 4.8 | 5.6±2.2 | 5.5±2.0 | Bushen Quhan Zhiwang decoction+Methotrexate | Methotrexate | 20 | ①② | ||||||||||||||||||
| Luo W et al 2013 | - | - | 20-55 | - | - | Bushen Quhan Zhiwang decoction+Methotrexate+Total Glucosides of Peony | Methotrexate+Total Glucosides of Peony | 24 | ①②③④ | |||||||||||||||||||
| Miao XY et al 2012 | 9/21 | 11/19 | 48.8 | 48.9 | 6.1 | 5.95 | WD+Methotrexate+Diclofenac Sodium | Methotrexate+Diclofenac Sodium | 12 | ②③ | ||||||||||||||||||
| Qiu SB et al 2018 | 3/27 | 2/28 | 48.47± 6.54 | 49.82±5.84 | 7.42±5.37 | 6.84±6.34 | DJD+Methotrexate+Hydroxychloroquine+Meloxicam | Methotrexate+Hydroxychloroquine+Meloxicam | 24 | ①③④ | ||||||||||||||||||
| Shen JY et al 2019 | 11/24 | 10/25 | 58.49± 11.976 | 60.63±11.324 | - | - | BJTF+Methotrexate | Methotrexate | 24 | ①③④ | ||||||||||||||||||
| Included study | Cases (male/female, n) | Age (years) | Duration of illness (years) | Intervention | Treatment duration (weeks) | Outcome indicator | ||||||||||||||||||||||
| T | C | T | C | T | C | T | C | |||||||||||||||||||||
| Shi Y et al 2019 | 15/25 | 15/25 | 36.5±1.2 | 35.5± 2.7 | 6.5±1.2 | 4.5±0.7 | DJD+Methotrexate+Meloxicam | Methotrexate+Meloxicam | 12 | ① | ||||||||||||||||||
| Sun GM et al 2021 | 5/10 | 7/8 | 43.28± 7.45 | 43.84± 6.73 | 4.34± 2.58 | 4.27± 2.93 | WT+Methotrexate | Methotrexate | 8 | ①③④ | ||||||||||||||||||
| Wan LY et al 2016 | - | - | - | - | - | - | DJD+Leflunomide | Leflunomide | 24 | ①④ | ||||||||||||||||||
| Wang G et al 2021 | 12/18 | 10/20 | 42.5±9.8 | 45.3± 10.4 | 5.8±2.7 | 6.0±2.5 | Bushen Quhan Zhiwang decoction+Methotrexate | Methotrexate | 24 | ①③④ | ||||||||||||||||||
| Wang JM et al 2013 | 31/89 | 33/87 | 31.62± 14.28 | 33.93± 12.46 | 6.56± 4.63 | 7.17± 5.82 | Bushen Quhan Zhiwang decoction+Methotrexate | Methotrexate | 24 | ①②③④ | ||||||||||||||||||
| Wang JM et al et al 2018 | 27/73 | 29/71 | 38.37± 12.28 | 40.13± 12.00 | 5.33± 2.57 | 5.16± 2.64 | Bushen Qinghua Zhiwang decoction+Methotrexate | Methotrexate | 24 | ①②③④ | ||||||||||||||||||
| Wang X et al 2019 | 7/41 | 9/39 | 46.75± 9.84 | 45.60± 7.51 | 0.65± 0.276 | 0.62± 0.24 | WP+Methotrexate+Celecoxib | Methotrexate+Celecoxib | 12 | ①②③④ | ||||||||||||||||||
| Xu L et al 2012 | 5/25 | 5/25 | 54.20± 8.25 | 54.47± 8.68 | 8.93± 8.12 | 8.16± 8.06 | QTOL+Methotrexate+Hydroxychloroquine Sulphate+Celecoxib | Methotrexate+Hydro-xychloroquine Sulphate+Celecoxib | 8 | ①③④ | ||||||||||||||||||
| Xu ZY et al 2020 | 15/25 | 17/23 | 42.71± 3.09 | 42.36± 3.57 | 4.90± 2.21 | 4.85± 2.63 | Bushen Qinghua Zhiwang decoction+Methotrexate | Methotrexate | 24 | ①②③④ | ||||||||||||||||||
| Xue QL et al 2016 | 33/57 | 32/58 | 43.2±1.8 | 42.9± 2.3 | 7.3±1.5 | 7.2±0.8 | Bushen Quhan Zhiwang decoction +Methotrexate | Methotrexate | 24 | ①②③④ | ||||||||||||||||||
| Yan WC et al 2015 | 21/9 | 19/11 | 48.93 | 48.9 | 6.1 | 5.91 | WD+Methotrexate | Methotrexate | 12 | ①② | ||||||||||||||||||
| Yang F et al 2020 | 18/22 | 21/19 | 55.23± 3.35 | 54.44± 3.31 | 3.23± 1.12 | 3.21± 1.11 | DJD+Methotrexate | Methotrexate | 8 | ①②③④ | ||||||||||||||||||
| Yao MS et al 2013 | 3/27 | 5/25 | 45.17± 10.79 | 47.42± 11.47 | 3.98± 2.35 | 4.12± 2.56 | DJD+Methotrexate+Celebrex | Methotrexate+Celebrex | 8 | ①②③④ | ||||||||||||||||||
| Zhang BC et al 2017 | 27/23 | 26/24 | 44.53± 4.47 | 45.32± 3.68 | 8.21± 5.04 | 7.12± 5.2 | Bushen Quhan Zhiwang decoction+Methotrexate | Methotrexate | 20 | ① | ||||||||||||||||||
| Zhang L et al 2017 | 17/33 | 15/35 | 53.2± 10.1 | 53.1± 11.2 | 6.58± 2.41 | 6.56± 2.53 | Bushen Quhan Zhiwang decoction+Methotrexate | Methotrexate | 24 | ①② | ||||||||||||||||||
| Zhang WJ et al 2013 | 9/21 | 8/22 | 43.6±5.3 | 42.5± 4.7 | 0.29~8.6 | 0.36- 6.9 | DJD+Leflunomide | Leflunomide | 16 | ①③④ | ||||||||||||||||||
| Zhao HY et al 2021 | 3/18 | 5/19 | 53.17± 10.11 | 52.87± 10.07 | 2.48± 0.96 | 2.51± 0.93 | DJD+Antirheumatic drugs of Western Medicine | Western Medicine Antirheumatic Drugs | 24 | ③④ | ||||||||||||||||||
| Su DC et al 2022 | 20/22 | 19/23 | 48.23± 5.16 | 48.15± 5.07 | 6.31± 1.92 | 6.34± 1.89 | DJD+Methotrexate+Meloxicam | Methotrexate+Meloxicam | 12 | ① | ||||||||||||||||||
| Lan TY et al 2023 | 18/58 | 21/56 | 61.24± 10.23 | 61.01± 8.97 | 8.61± 6.99 | 8.16± 4.52 | BZD+cDMARDs | cDMARDs | 48 | ③④ | ||||||||||||||||||
| Liu X 2022 | 11/21 | 10/22 | 58.27± 6.74 | 57.86± 6.05 | 1.73± 0.42 | 1.65± 0.38 | DJD+Leflunomide+Celebrex | Leflunomide+Celebrex | 8 | ①②③ | ||||||||||||||||||
| Yao CH et al 2023 | 2/20 | 3/17 | 55.36± 9.85 | 53.5± 12.48 | 6.54 (2.88, 9.25) | 8.33 (4.88, 13.25) | BZD+cDMARDs | cDMARDs | 48 | ①②③④ | ||||||||||||||||||
Table 1 Basic characteristics of the included literature
| Included study | Cases (male/female, n) | Age (years) | Duration of illness (years) | Intervention | Treatment duration (weeks) | Outcome indicator | ||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| T | C | T | C | T | C | T | C | |||||||||||||||||||||
| Chen D et al 2018 | 9/16 | 8/17 | 34.4± 15.54 | 34.45±15.85 | 6.75±3.97 | 6.67±3.62 | Bushen Quhan Zhiwang decoction + Methotrexate | Methotrexate | 24 | ①② | ||||||||||||||||||
| Chen F et al 2016 | 11/24 | 13/22 | 37.52± 6.61 | 37.34±6.48 | 2.2±0.51 | 2.1±0.37 | YJC+Methotrexate+Leflunomide+Celecoxib | Methotrexate+Leflunomide+Celecoxib | 8 | ①②③④ | ||||||||||||||||||
| Chen L et al 2021 | 31/144 | 33/142 | 47.28± 12.19 | 49.11±11.62 | ≤1 | WT+Methotrexate+Acetaminophen | Methotrexate+WT analog+Acetaminophen | 12 | ② | |||||||||||||||||||
| Chen XL et al 2020 | 7/23 | 8/22 | 41.6±5.2 | 42.8± 4.7 | 3.2 | 3.3 | DJD+Leflunomide | Leflunomide | 8 | ④ | ||||||||||||||||||
| Chen YG et al 2019 | 2/23 | 4/21 | 51.4±5.8 | 53.6± 8.6 | 8.0±3.9 | 7.9±4.1 | DJD+Methotrexate+Leflunomide+Meloxicam | Methotrexate+Leflunomide+Meloxicam | 12 | ①②③④ | ||||||||||||||||||
| Du DY et al 2019 | 16/32 | 18/30 | 44.75± 6.73 | 44.80±6.69 | 4.24±1.61 | 4.24±1.61 | DJD+Methotrexate+Meloxicam | Methotrexate+meloxicam | 4 | ①②③④ | ||||||||||||||||||
| Gao Y et al 2015 | 14/46 | 15/45 | 64.0±3.2 | <1 | YJC+Methotrexate+Etoricoxib | Methotrexate+Etoricoxib | 12 | ②③④ | ||||||||||||||||||||
| He CX et al 2018 | - | - | 49.77± 11.43 | 49.74±11.59 | 7.13±6.74 | 6.8±6.04 | Bushen Quhan Zhiwang decoction+Methotrexate | Methotrexate | 12 | ①②③④ | ||||||||||||||||||
| He YK et al 2015 | 3/26 | 4/23 | 42.86± 9.54 | 47.26±13.56 | 11.34±7.35 | 12.04±7.88 | BJTF+Methotrexate | Methotrexate | 12 | ② | ||||||||||||||||||
| He YK et al 2018 | 9/29 | 12/28 | 48.14± 10.24 | 49.59±11.78 | 10.51±6.98 | 11.01±6.58 | BJTF+Methotrexate | Methotrexate | 24 | ①③④ | ||||||||||||||||||
| Hou HL et al 2013 | 6/24 | 7/23 | 52.63± 11.57 | 51.86±11.09 | 3.90±3.14 | 5.01±4.54 | WP+Methotrexate+Meloxicam | Methotrexate+Meloxicam | 4 | ①③④ | ||||||||||||||||||
| Ji HW et al 2012 | - | - | 26-64 | 0.25~20 | WT+Methotrexate | Methotrexate | 8 | ①②③④ | ||||||||||||||||||||
| Li N et al 2014 | 14/36 | 12/38 | 46.5±5.1 | 46.1± 4.8 | 5.2±2.3 | 5.4±2.2 | Bushen Quhan Zhiwang decoction+Methotrexate | Methotrexate | 20 | ①② | ||||||||||||||||||
| Li SQ et al 2017 | 15/28 | 13/30 | 43.2±6.3 | 41.7± 6.3 | 4.1±2.8 | 4.9±2.7 | Bushen Quhan Zhiwang decoction+Methotrexate | Methotrexate | 20 | ①② | ||||||||||||||||||
| Li XL et al 2015 | 10/24 | 11/23 | 43.5±7.2 | 44.7± 7.2 | 7.2±2.1 | 7.14±2.2 | QTOL+Methotrexate | Methotrexate | 8 | ①③④ | ||||||||||||||||||
| Liang J et al 2015 | 6/28 | 9/19 | 35.2± 13.6 | 36.1± 12.2 | 1.4±0.6 | 1.3±0.5 | Bushen Quhan Zhiwang decoction+Methotrexate | Methotrexate | 3 | ①②③④ | ||||||||||||||||||
| Lin GY et al 2016 | 42/33 | 40/35 | 47.4±4.2 | 46.4± 4.8 | 5.6±2.2 | 5.5±2.0 | Bushen Quhan Zhiwang decoction+Methotrexate | Methotrexate | 20 | ①② | ||||||||||||||||||
| Luo W et al 2013 | - | - | 20-55 | - | - | Bushen Quhan Zhiwang decoction+Methotrexate+Total Glucosides of Peony | Methotrexate+Total Glucosides of Peony | 24 | ①②③④ | |||||||||||||||||||
| Miao XY et al 2012 | 9/21 | 11/19 | 48.8 | 48.9 | 6.1 | 5.95 | WD+Methotrexate+Diclofenac Sodium | Methotrexate+Diclofenac Sodium | 12 | ②③ | ||||||||||||||||||
| Qiu SB et al 2018 | 3/27 | 2/28 | 48.47± 6.54 | 49.82±5.84 | 7.42±5.37 | 6.84±6.34 | DJD+Methotrexate+Hydroxychloroquine+Meloxicam | Methotrexate+Hydroxychloroquine+Meloxicam | 24 | ①③④ | ||||||||||||||||||
| Shen JY et al 2019 | 11/24 | 10/25 | 58.49± 11.976 | 60.63±11.324 | - | - | BJTF+Methotrexate | Methotrexate | 24 | ①③④ | ||||||||||||||||||
| Included study | Cases (male/female, n) | Age (years) | Duration of illness (years) | Intervention | Treatment duration (weeks) | Outcome indicator | ||||||||||||||||||||||
| T | C | T | C | T | C | T | C | |||||||||||||||||||||
| Shi Y et al 2019 | 15/25 | 15/25 | 36.5±1.2 | 35.5± 2.7 | 6.5±1.2 | 4.5±0.7 | DJD+Methotrexate+Meloxicam | Methotrexate+Meloxicam | 12 | ① | ||||||||||||||||||
| Sun GM et al 2021 | 5/10 | 7/8 | 43.28± 7.45 | 43.84± 6.73 | 4.34± 2.58 | 4.27± 2.93 | WT+Methotrexate | Methotrexate | 8 | ①③④ | ||||||||||||||||||
| Wan LY et al 2016 | - | - | - | - | - | - | DJD+Leflunomide | Leflunomide | 24 | ①④ | ||||||||||||||||||
| Wang G et al 2021 | 12/18 | 10/20 | 42.5±9.8 | 45.3± 10.4 | 5.8±2.7 | 6.0±2.5 | Bushen Quhan Zhiwang decoction+Methotrexate | Methotrexate | 24 | ①③④ | ||||||||||||||||||
| Wang JM et al 2013 | 31/89 | 33/87 | 31.62± 14.28 | 33.93± 12.46 | 6.56± 4.63 | 7.17± 5.82 | Bushen Quhan Zhiwang decoction+Methotrexate | Methotrexate | 24 | ①②③④ | ||||||||||||||||||
| Wang JM et al et al 2018 | 27/73 | 29/71 | 38.37± 12.28 | 40.13± 12.00 | 5.33± 2.57 | 5.16± 2.64 | Bushen Qinghua Zhiwang decoction+Methotrexate | Methotrexate | 24 | ①②③④ | ||||||||||||||||||
| Wang X et al 2019 | 7/41 | 9/39 | 46.75± 9.84 | 45.60± 7.51 | 0.65± 0.276 | 0.62± 0.24 | WP+Methotrexate+Celecoxib | Methotrexate+Celecoxib | 12 | ①②③④ | ||||||||||||||||||
| Xu L et al 2012 | 5/25 | 5/25 | 54.20± 8.25 | 54.47± 8.68 | 8.93± 8.12 | 8.16± 8.06 | QTOL+Methotrexate+Hydroxychloroquine Sulphate+Celecoxib | Methotrexate+Hydro-xychloroquine Sulphate+Celecoxib | 8 | ①③④ | ||||||||||||||||||
| Xu ZY et al 2020 | 15/25 | 17/23 | 42.71± 3.09 | 42.36± 3.57 | 4.90± 2.21 | 4.85± 2.63 | Bushen Qinghua Zhiwang decoction+Methotrexate | Methotrexate | 24 | ①②③④ | ||||||||||||||||||
| Xue QL et al 2016 | 33/57 | 32/58 | 43.2±1.8 | 42.9± 2.3 | 7.3±1.5 | 7.2±0.8 | Bushen Quhan Zhiwang decoction +Methotrexate | Methotrexate | 24 | ①②③④ | ||||||||||||||||||
| Yan WC et al 2015 | 21/9 | 19/11 | 48.93 | 48.9 | 6.1 | 5.91 | WD+Methotrexate | Methotrexate | 12 | ①② | ||||||||||||||||||
| Yang F et al 2020 | 18/22 | 21/19 | 55.23± 3.35 | 54.44± 3.31 | 3.23± 1.12 | 3.21± 1.11 | DJD+Methotrexate | Methotrexate | 8 | ①②③④ | ||||||||||||||||||
| Yao MS et al 2013 | 3/27 | 5/25 | 45.17± 10.79 | 47.42± 11.47 | 3.98± 2.35 | 4.12± 2.56 | DJD+Methotrexate+Celebrex | Methotrexate+Celebrex | 8 | ①②③④ | ||||||||||||||||||
| Zhang BC et al 2017 | 27/23 | 26/24 | 44.53± 4.47 | 45.32± 3.68 | 8.21± 5.04 | 7.12± 5.2 | Bushen Quhan Zhiwang decoction+Methotrexate | Methotrexate | 20 | ① | ||||||||||||||||||
| Zhang L et al 2017 | 17/33 | 15/35 | 53.2± 10.1 | 53.1± 11.2 | 6.58± 2.41 | 6.56± 2.53 | Bushen Quhan Zhiwang decoction+Methotrexate | Methotrexate | 24 | ①② | ||||||||||||||||||
| Zhang WJ et al 2013 | 9/21 | 8/22 | 43.6±5.3 | 42.5± 4.7 | 0.29~8.6 | 0.36- 6.9 | DJD+Leflunomide | Leflunomide | 16 | ①③④ | ||||||||||||||||||
| Zhao HY et al 2021 | 3/18 | 5/19 | 53.17± 10.11 | 52.87± 10.07 | 2.48± 0.96 | 2.51± 0.93 | DJD+Antirheumatic drugs of Western Medicine | Western Medicine Antirheumatic Drugs | 24 | ③④ | ||||||||||||||||||
| Su DC et al 2022 | 20/22 | 19/23 | 48.23± 5.16 | 48.15± 5.07 | 6.31± 1.92 | 6.34± 1.89 | DJD+Methotrexate+Meloxicam | Methotrexate+Meloxicam | 12 | ① | ||||||||||||||||||
| Lan TY et al 2023 | 18/58 | 21/56 | 61.24± 10.23 | 61.01± 8.97 | 8.61± 6.99 | 8.16± 4.52 | BZD+cDMARDs | cDMARDs | 48 | ③④ | ||||||||||||||||||
| Liu X 2022 | 11/21 | 10/22 | 58.27± 6.74 | 57.86± 6.05 | 1.73± 0.42 | 1.65± 0.38 | DJD+Leflunomide+Celebrex | Leflunomide+Celebrex | 8 | ①②③ | ||||||||||||||||||
| Yao CH et al 2023 | 2/20 | 3/17 | 55.36± 9.85 | 53.5± 12.48 | 6.54 (2.88, 9.25) | 8.33 (4.88, 13.25) | BZD+cDMARDs | cDMARDs | 48 | ①②③④ | ||||||||||||||||||
Figure 1 Flowchart of the literature screening process
Figure 1 Flowchart of the literature screening process
Figure 2 Evidence network diagrams for four outcome indicators A: evidence network diagram for total effective rate; B: evidence network diagram for incidence of adverse reactions; C: evidence network diagram for CRP; D: evidence network diagram for ESR. W: conventional Western Medicine; A + W: Bushen Quhan Zhiwang decoction + conventional Western Medicine; B + W: Yishen Juanbi capsules + conventional Western Medicine; C + W: Wangbi tablets + conventional Western Medicine; D + W: Duhuo Jisheng decoction + conventional Western Medicine; E + W: Bushen Jiedu Tongluo formula + conventional Western Medicine; F + W: Wanbikang pills + conventional Western Medicine; G + W: Qiwei Tongbi oral liquid + conventional Western Medicine; H + W: Wanbi decoction + conventional Western Medicine; I + W: Bushen Qinghua Zhiwang decoction + conventional Western Medicine; J + W: Bushen Zhiwang decoction + conventional Western Medicine.
Figure 2 Evidence network diagrams for four outcome indicators A: evidence network diagram for total effective rate; B: evidence network diagram for incidence of adverse reactions; C: evidence network diagram for CRP; D: evidence network diagram for ESR. W: conventional Western Medicine; A + W: Bushen Quhan Zhiwang decoction + conventional Western Medicine; B + W: Yishen Juanbi capsules + conventional Western Medicine; C + W: Wangbi tablets + conventional Western Medicine; D + W: Duhuo Jisheng decoction + conventional Western Medicine; E + W: Bushen Jiedu Tongluo formula + conventional Western Medicine; F + W: Wanbikang pills + conventional Western Medicine; G + W: Qiwei Tongbi oral liquid + conventional Western Medicine; H + W: Wanbi decoction + conventional Western Medicine; I + W: Bushen Qinghua Zhiwang decoction + conventional Western Medicine; J + W: Bushen Zhiwang decoction + conventional Western Medicine.
Table 2 Direct pairwise Meta-analysis of the total effective rate
| Item | Number of studies (n) | Test group (events/total, n) | Control group (events/total, n) | Effect measure RR (95% CI) | Heterogeneity (I 2, %) |
|---|---|---|---|---|---|
| Bushen Quhan Zhiwang decoction | 12 | 554/675 | 431/652 | 1.24 (1.17, 1.32)a | 0.0 |
| YJC | 1 | 31/33 | 24/32 | 1.25 (1.01, 1.56)a | - |
| WT | 2 | 23/25 | 12/25 | 1.92 (1.25, 2.72)a | 0.0 |
| DJD | 10 | 297/377 | 219/377 | 1.28 (1.19, 1.37)a | 0.0 |
| BJTF | 2 | 51/70 | 30/70 | 1.70 (1.26, 2.30)a | 0.0 |
| WP | 2 | 65/74 | 47/75 | 1.41 (1.03, 1.93)a | 53.6 |
| QTOL | 2 | 51/64 | 40/64 | 1.27 (1.02, 1.59)a | 0.0 |
| WD | 1 | 29/30 | 21/30 | 1.38 (1.08, 1.76)a | - |
| Bushen Qinghua Zhiwang decoction | 1 | 37/40 | 30/40 | 1.23 (1.01, 1.51)a | - |
| BZD | 1 | 20/22 | 14/20 | 1.20 (0.95, 1.78) | - |
Table 2 Direct pairwise Meta-analysis of the total effective rate
| Item | Number of studies (n) | Test group (events/total, n) | Control group (events/total, n) | Effect measure RR (95% CI) | Heterogeneity (I 2, %) |
|---|---|---|---|---|---|
| Bushen Quhan Zhiwang decoction | 12 | 554/675 | 431/652 | 1.24 (1.17, 1.32)a | 0.0 |
| YJC | 1 | 31/33 | 24/32 | 1.25 (1.01, 1.56)a | - |
| WT | 2 | 23/25 | 12/25 | 1.92 (1.25, 2.72)a | 0.0 |
| DJD | 10 | 297/377 | 219/377 | 1.28 (1.19, 1.37)a | 0.0 |
| BJTF | 2 | 51/70 | 30/70 | 1.70 (1.26, 2.30)a | 0.0 |
| WP | 2 | 65/74 | 47/75 | 1.41 (1.03, 1.93)a | 53.6 |
| QTOL | 2 | 51/64 | 40/64 | 1.27 (1.02, 1.59)a | 0.0 |
| WD | 1 | 29/30 | 21/30 | 1.38 (1.08, 1.76)a | - |
| Bushen Qinghua Zhiwang decoction | 1 | 37/40 | 30/40 | 1.23 (1.01, 1.51)a | - |
| BZD | 1 | 20/22 | 14/20 | 1.20 (0.95, 1.78) | - |
Figure 3 Comparative-corrected funnel plots for four outcome indicators A: comparative-corrected funnel plot for total effective rate; B: comparative-corrected funnel plot for incidence of adverse reactions; C: comparative-corrected funnel plot for CRP; D: comparative-corrected funnel plot for ESR. W: conventional Western Medicine; A + W: Bushen Quhan Zhiwang decoction + conventional Western Medicine; B + W: Yishen Juanbi capsules + conventional Western Medicine; C + W: Wangbi tablets + conventional Western Medicine; D + W: Duhuo Jisheng decoction + conventional Western Medicine; E + W: Bushen Jiedu Tongluo formula + conventional Western Medicine; F + W: Wanbikang pills + conventional Western Medicine; G + W: Qiwei Tongbi oral liquid + conventional Western Medicine; H + W: Wanbi decoction + conventional Western Medicine; I + W: Bushen Qinghua Zhiwang decoction + conventional Western Medicine; J + W: Bushen Zhiwang decoction + conventional Western Medicine. CRP: C-reactive protein; ESR: Erythrocyte sedimentation rate.
Figure 3 Comparative-corrected funnel plots for four outcome indicators A: comparative-corrected funnel plot for total effective rate; B: comparative-corrected funnel plot for incidence of adverse reactions; C: comparative-corrected funnel plot for CRP; D: comparative-corrected funnel plot for ESR. W: conventional Western Medicine; A + W: Bushen Quhan Zhiwang decoction + conventional Western Medicine; B + W: Yishen Juanbi capsules + conventional Western Medicine; C + W: Wangbi tablets + conventional Western Medicine; D + W: Duhuo Jisheng decoction + conventional Western Medicine; E + W: Bushen Jiedu Tongluo formula + conventional Western Medicine; F + W: Wanbikang pills + conventional Western Medicine; G + W: Qiwei Tongbi oral liquid + conventional Western Medicine; H + W: Wanbi decoction + conventional Western Medicine; I + W: Bushen Qinghua Zhiwang decoction + conventional Western Medicine; J + W: Bushen Zhiwang decoction + conventional Western Medicine. CRP: C-reactive protein; ESR: Erythrocyte sedimentation rate.
Table 3 Direct pairwise Meta-analysis of the incidence of adverse reactions
| Item | Number of studies (n) | Test group (events/total, n) | Control group (events/total, n) | Effect measure RR (95% CI) | Heterogeneity (I 2, %) |
|---|---|---|---|---|---|
| Bushen Quhan Zhiwang decoction | 11 | 31/591 | 124/568 | 0.24 (0.17, 0.36)a | 0.0 |
| YJC | 2 | 12/93 | 12/92 | 0.98 (0.47, 2.03) | 0.0 |
| WT | 2 | 32/183 | 30/185 | 1.08 (0.69, 1.68) | 15.9 |
| DJD | 5 | 15/175 | 32/175 | 0.47 (0.27, 0.83)a | 49.9 |
| WP | 2 | 14/74 | 16/75 | 0.89 (0.47, 1.69) | 0.0 |
| WD | 2 | 2/60 | 7/60 | 0.29 (0.06, 1.32) | 0.0 |
| Bushen Qinghua Zhiwang decoction | 1 | 2/40 | 8/40 | 0.25 (0.06, 1.11) | - |
| BZD | 1 | 1/22 | 1/20 | 0.91 (0.06, 13.59) | - |
Table 3 Direct pairwise Meta-analysis of the incidence of adverse reactions
| Item | Number of studies (n) | Test group (events/total, n) | Control group (events/total, n) | Effect measure RR (95% CI) | Heterogeneity (I 2, %) |
|---|---|---|---|---|---|
| Bushen Quhan Zhiwang decoction | 11 | 31/591 | 124/568 | 0.24 (0.17, 0.36)a | 0.0 |
| YJC | 2 | 12/93 | 12/92 | 0.98 (0.47, 2.03) | 0.0 |
| WT | 2 | 32/183 | 30/185 | 1.08 (0.69, 1.68) | 15.9 |
| DJD | 5 | 15/175 | 32/175 | 0.47 (0.27, 0.83)a | 49.9 |
| WP | 2 | 14/74 | 16/75 | 0.89 (0.47, 1.69) | 0.0 |
| WD | 2 | 2/60 | 7/60 | 0.29 (0.06, 1.32) | 0.0 |
| Bushen Qinghua Zhiwang decoction | 1 | 2/40 | 8/40 | 0.25 (0.06, 1.11) | - |
| BZD | 1 | 1/22 | 1/20 | 0.91 (0.06, 13.59) | - |
Table 4 Direct pairwise Meta-analysis of CRP
| Item | Number of studies (n) | Test group (n) | Control group (n) | Effect measure MD (95% CI) | Heterogeneity (I 2, %) | |
|---|---|---|---|---|---|---|
| Bushen Quhan Zhiwang decoction | 6 | 348 | 348 | －1.96 (－3.79, －0.12)a | 85.4 | |
| YJC | 2 | 93 | 92 | －4.28 (－5.33, －3.23)a | 0.0 | |
| WT | 2 | 25 | 25 | －2.63 (－5.00, －0.26)a | 0.0 | |
| DJD | 8 | 259 | 259 | －4.48 (－5.26, －3.70)a | 80.5 | |
| BJTF | 2 | 70 | 70 | －5.75 (－17.89, 6.38) | 84.8 | |
| WP | 2 | 74 | 75 | －8.79 (－22.79, 5.20) | 86.4 | |
| QTOL | 2 | 64 | 64 | －10.53 (－17.28, －3.78)a | 54.2 | |
| WD | 1 | 30 | 30 | －3.12 (－5.85, －0.39)a | - | |
| Bushen Qinghua Zhiwang decoction | 2 | 140 | 140 | －4.78 (－10.79, 1.24) | 96.4 | |
| BZD | 2 | 98 | 97 | －0.46 (－0.91, －0.01)a | 78.5 | |
Table 4 Direct pairwise Meta-analysis of CRP
| Item | Number of studies (n) | Test group (n) | Control group (n) | Effect measure MD (95% CI) | Heterogeneity (I 2, %) | |
|---|---|---|---|---|---|---|
| Bushen Quhan Zhiwang decoction | 6 | 348 | 348 | －1.96 (－3.79, －0.12)a | 85.4 | |
| YJC | 2 | 93 | 92 | －4.28 (－5.33, －3.23)a | 0.0 | |
| WT | 2 | 25 | 25 | －2.63 (－5.00, －0.26)a | 0.0 | |
| DJD | 8 | 259 | 259 | －4.48 (－5.26, －3.70)a | 80.5 | |
| BJTF | 2 | 70 | 70 | －5.75 (－17.89, 6.38) | 84.8 | |
| WP | 2 | 74 | 75 | －8.79 (－22.79, 5.20) | 86.4 | |
| QTOL | 2 | 64 | 64 | －10.53 (－17.28, －3.78)a | 54.2 | |
| WD | 1 | 30 | 30 | －3.12 (－5.85, －0.39)a | - | |
| Bushen Qinghua Zhiwang decoction | 2 | 140 | 140 | －4.78 (－10.79, 1.24) | 96.4 | |
| BZD | 2 | 98 | 97 | －0.46 (－0.91, －0.01)a | 78.5 | |
Table 5 Direct pairwise Meta-analysis of ESR
| Item | Number of studies (n) | Test group (n) | Control group (n) | Effect measure MD (95% CI) | Heterogeneity (I 2, %) |
|---|---|---|---|---|---|
| Bushen Quhan Zhiwang decoction | 6 | 348 | 325 | －2.63 (－3.49, －1.77)a | 39.8 |
| YJC | 2 | 93 | 92 | －7.88 (－8.78, －6.99)a | 41.1 |
| WT | 2 | 25 | 25 | －8.51 (－14.95, －2.07)a | 19.4 |
| DJD | 9 | 317 | 317 | －10.13 (－14.04, －6.22)a | 92.6 |
| BJTF | 2 | 70 | 70 | －2.99 (－12.20, 6.23) | 0.0 |
| WP | 2 | 74 | 75 | －6.73 (－12.59, －0.86)a | 0.0 |
| QTOL | 2 | 64 | 64 | －13.31 (－17.81, －8.82)a | 0.0 |
| Bushen Qinghua Zhiwang decoction | 2 | 140 | 140 | －10.66 (－23.16, 1.83) | 96.4 |
| BZD | 2 | 98 | 97 | －12.38 (－16.36, －8.40)a | 78.5 |
Table 5 Direct pairwise Meta-analysis of ESR
| Item | Number of studies (n) | Test group (n) | Control group (n) | Effect measure MD (95% CI) | Heterogeneity (I 2, %) |
|---|---|---|---|---|---|
| Bushen Quhan Zhiwang decoction | 6 | 348 | 325 | －2.63 (－3.49, －1.77)a | 39.8 |
| YJC | 2 | 93 | 92 | －7.88 (－8.78, －6.99)a | 41.1 |
| WT | 2 | 25 | 25 | －8.51 (－14.95, －2.07)a | 19.4 |
| DJD | 9 | 317 | 317 | －10.13 (－14.04, －6.22)a | 92.6 |
| BJTF | 2 | 70 | 70 | －2.99 (－12.20, 6.23) | 0.0 |
| WP | 2 | 74 | 75 | －6.73 (－12.59, －0.86)a | 0.0 |
| QTOL | 2 | 64 | 64 | －13.31 (－17.81, －8.82)a | 0.0 |
| Bushen Qinghua Zhiwang decoction | 2 | 140 | 140 | －10.66 (－23.16, 1.83) | 96.4 |
| BZD | 2 | 98 | 97 | －12.38 (－16.36, －8.40)a | 78.5 |
Table 6 Network Meta－analysis of the total effective rate (lower left) and network Meta-analysis of the incidence of adverse reactions (upper right)
| A+W | 0.21 (0.08, 0.56)a | 0.19 (0.09, 0.38)a | 0.55 (0.23, 1.28) | － | 0.24 (0.10, 0.59)a | － | 0.78 (0.15, 4.17) | 0.98 (0.18, 5.21) | 0.23 (0.01, 4.02) | 0.21 (0.14, 0.31)a |
|---|---|---|---|---|---|---|---|---|---|---|
| 0.53 (0.10, 2.79) | B+W | 0.89 (0.31, 2.53) | 2.59 (0.82, 8.20) | － | 1.14 (0.34, 3.76) | － | 3.72 (0.59, 23.52) | 4.64 (0.73, 29.36) | 1.08 (0.06, 21.15) | 0.98 (0.40, 2.36) |
| 0.31 (0.06, 1.52) | 0.59 (0.06, 5.68) | C+W | 2.92 (1.16, 7.38) | － | 1.28 (0.48, 3.42) | － | 4.19 (0.76, 23.24) | 5.23 (0.94, 29.01) | 1.22 (0.07, 22.00) | 1.10 (0.63, 1.93) |
| 0.70 (0.41, 1.17) | 1.32 (0.24, 7.17) | 2.22 (0.44, 11.15) | D+W | － | 0.44 (0.15, 1.31) | － | 1.44 (0.24, 8.50) | 1.79 (0.30, 10.61) | 0.42 (0.02, 7.83) | 0.38 (0.18, 0.79)a |
| 0.74 (0.33, 1.63) | 1.40 (0.23, 8.44) | 2.36 (0.42, 13.19) | 1.06 (0.45, 2.50) | E+W | － | － | － | － | － | － |
| 0.63 (0.26, 1.53) | 1.19 (0.19, 7.51) | 2.00 (0.34, 11.76) | 0.90 (0.35, 2.33) | 0.85 (0.28, 2.61) | F+W | － | 3.28 (0.54, 20.00) | 4.09 (0.67, 24.97) | 0.95 (0.05, 18.23) | 0.86 (0.38, 1.93) |
| 1.12 (0.48, 2.65) | 2.13 (0.34, 13.21) | 3.59 (0.62, 20.68) | 1.61 (0.65, 4.03) | 1.52 (0.51, 4.55) | 1.79 (0.56, 5.77) | G+W | － | － | － | － |
| 0.22 (0.03, 1.90) | 0.42 (0.03, 6.16) | 0.70 (0.05, 9.88) | 0.32 (0.04, 2.80) | 0.30 (0.03, 2.87) | 0.35 (0.04, 3.50) | 0.20 (0.02, 1.93) | H+W | 1.25 (0.13, 12.30) | 0.29 (0.01, 7.62) | 0.26 (0.05, 1.32) |
| 0.66 (0.16, 2.71) | 1.26 (0.15, 10.69) | 2.12 (0.27, 16.92) | 0.95 (0.23, 4.04) | 0.90 (0.19, 4.29) | 1.06 (0.21, 5.33) | 0.59 (0.12, 2.92) | 3.02 (0.24, 38.55) | I+W | 0.23 (0.01, 6.12) | 0.21 (0.04, 1.06) |
| 0.64 (0.11, 3.71) | 1.21 (0.11, 13.16) | 2.03 (0.20, 20.97) | 0.92 (0.15, 5.49) | 0.86 (0.13, 5.71) | 1.02 (0.15, 7.03) | 0.57 (0.08, 3.86) | 2.90 (0.18, 45.76) | 0.96 (0.10, 8.82) | J+W | 0.90 (0.05, 15.49) |
| 2.73 (2.03, 3.65)a | 5.17 (1.00, 26.60)a | 8.71 (1.84, 41.26)a | 3.92 (2.55, 6.03)a | 3.70 (1.76, 7.75)a | 4.35 (1.87, 10.14)a | 2.43 (1.08, 5.45)a | 12.43 (1.46, 105.74)a | 4.11 (1.04, 16.29)a | 4.29 (0.75, 24.42) | W |
Table 6 Network Meta－analysis of the total effective rate (lower left) and network Meta-analysis of the incidence of adverse reactions (upper right)
| A+W | 0.21 (0.08, 0.56)a | 0.19 (0.09, 0.38)a | 0.55 (0.23, 1.28) | － | 0.24 (0.10, 0.59)a | － | 0.78 (0.15, 4.17) | 0.98 (0.18, 5.21) | 0.23 (0.01, 4.02) | 0.21 (0.14, 0.31)a |
|---|---|---|---|---|---|---|---|---|---|---|
| 0.53 (0.10, 2.79) | B+W | 0.89 (0.31, 2.53) | 2.59 (0.82, 8.20) | － | 1.14 (0.34, 3.76) | － | 3.72 (0.59, 23.52) | 4.64 (0.73, 29.36) | 1.08 (0.06, 21.15) | 0.98 (0.40, 2.36) |
| 0.31 (0.06, 1.52) | 0.59 (0.06, 5.68) | C+W | 2.92 (1.16, 7.38) | － | 1.28 (0.48, 3.42) | － | 4.19 (0.76, 23.24) | 5.23 (0.94, 29.01) | 1.22 (0.07, 22.00) | 1.10 (0.63, 1.93) |
| 0.70 (0.41, 1.17) | 1.32 (0.24, 7.17) | 2.22 (0.44, 11.15) | D+W | － | 0.44 (0.15, 1.31) | － | 1.44 (0.24, 8.50) | 1.79 (0.30, 10.61) | 0.42 (0.02, 7.83) | 0.38 (0.18, 0.79)a |
| 0.74 (0.33, 1.63) | 1.40 (0.23, 8.44) | 2.36 (0.42, 13.19) | 1.06 (0.45, 2.50) | E+W | － | － | － | － | － | － |
| 0.63 (0.26, 1.53) | 1.19 (0.19, 7.51) | 2.00 (0.34, 11.76) | 0.90 (0.35, 2.33) | 0.85 (0.28, 2.61) | F+W | － | 3.28 (0.54, 20.00) | 4.09 (0.67, 24.97) | 0.95 (0.05, 18.23) | 0.86 (0.38, 1.93) |
| 1.12 (0.48, 2.65) | 2.13 (0.34, 13.21) | 3.59 (0.62, 20.68) | 1.61 (0.65, 4.03) | 1.52 (0.51, 4.55) | 1.79 (0.56, 5.77) | G+W | － | － | － | － |
| 0.22 (0.03, 1.90) | 0.42 (0.03, 6.16) | 0.70 (0.05, 9.88) | 0.32 (0.04, 2.80) | 0.30 (0.03, 2.87) | 0.35 (0.04, 3.50) | 0.20 (0.02, 1.93) | H+W | 1.25 (0.13, 12.30) | 0.29 (0.01, 7.62) | 0.26 (0.05, 1.32) |
| 0.66 (0.16, 2.71) | 1.26 (0.15, 10.69) | 2.12 (0.27, 16.92) | 0.95 (0.23, 4.04) | 0.90 (0.19, 4.29) | 1.06 (0.21, 5.33) | 0.59 (0.12, 2.92) | 3.02 (0.24, 38.55) | I+W | 0.23 (0.01, 6.12) | 0.21 (0.04, 1.06) |
| 0.64 (0.11, 3.71) | 1.21 (0.11, 13.16) | 2.03 (0.20, 20.97) | 0.92 (0.15, 5.49) | 0.86 (0.13, 5.71) | 1.02 (0.15, 7.03) | 0.57 (0.08, 3.86) | 2.90 (0.18, 45.76) | 0.96 (0.10, 8.82) | J+W | 0.90 (0.05, 15.49) |
| 2.73 (2.03, 3.65)a | 5.17 (1.00, 26.60)a | 8.71 (1.84, 41.26)a | 3.92 (2.55, 6.03)a | 3.70 (1.76, 7.75)a | 4.35 (1.87, 10.14)a | 2.43 (1.08, 5.45)a | 12.43 (1.46, 105.74)a | 4.11 (1.04, 16.29)a | 4.29 (0.75, 24.42) | W |
Table 7 Network Meta-analysis of CRP (lower left) and network Meta-analysis of ESR (upper right)
| A+W | －2.67 (－11.62, 6.28) | －6.18 (－18.05, 5.69) | －6.26 (－12.35, －0.17)a | 0.86 (－12.05, 13.76) | －2.34 (－13.49, 8.81) | －8.47 (－18.93, 1.99) | － | －6.68 (－15.65, 2.30) | －8.02 (－17.56, 1.53) | 3.88 (－0.76, 8.52) |
|---|---|---|---|---|---|---|---|---|---|---|
| －2.56 (－9.24, 4.11) | B+W | －3.51 (－16.88, 9.85) | －3.59 (－12.22, 5.04) | 3.53 (－10.74, 17.80) | 0.33 (－12.37, 13.03) | －5.80 (－17.89, 6.29) | － | －4.01 (－14.86, 6.84) | －5.35 (－16.66, 5.97) | 6.55 (－1.11, 14.21) |
| 0.82 (－6.37, 8.01) | 3.38 (－5.30, 12.07) | C+W | －0.08 (－11.70, 11.54) | 7.04 (－9.23, 23.31) | 3.84 (－11.09, 18.77) | －2.29 (－16.72, 12.14) | － | －0.50 (－13.86, 12.87) | －1.84 (－15.60, 11.93) | 10.06 (－0.88, 21.01) |
| －4.11 (－8.65, 0.43) | －1.54 (－8.22, 5.13) | －4.93 (－12.14, 2.28) | D+W | 7.12 (－5.56, 19.80) | 3.92 (－6.97, 14.81) | －2.21 (－12.39, 7.98) | － | －0.42 (－9.06, 8.22) | －1.76 (－10.99, 7.48) | 10.14 (6.17, 14.11)a |
| －1.16 (－7.80, 5.49) | 1.41 (－6.84, 9.66) | －1.98 (－10.66, 6.71) | 2.95 (－3.67, 9.57) | E+W | －3.20 (－18.94, 12.54) | －9.33 (－24.58, 5.93) | － | －7.54 (－21.82, 6.75) | －8.87 (－23.52, 5.77) | 3.02 (－9.02, 15.06) |
| －4.07 (－11.60, 3.46) | －1.50 (－10.49, 7.49) | －4.89 (－14.33, 4.56) | 0.04 (－7.41, 7.50) | －2.91 (－11.83, 6.00) | F+W | －6.13 (－19.92, 7.66) | － | －4.34 (－17.06, 8.38) | －5.68(－18.79, 7.44) | 6.22 (－3.91, 16.35) |
| －8.05 (－15.42, －0.68)a | －5.48 (－14.33, 3.36) | －8.87 (－18.14, 0.40) | －3.94 (－11.27, 3.39) | －6.89 (－15.69, 1.90) | －3.98 (－13.40, 5.44) | G+W | － | 1.79 (－10.33, 13.91) | 0.45 (－12.08, 12.99) | 12.35 (2.98, 21.72)a |
| －0.69 (－9.33, 7.95) | 1.88 (－8.04, 11.80) | －1.51 (－11.77, 8.76) | 3.42 (－5.22, 12.06) | 0.47 (－9.44, 10.38) | 3.38 (－7.16, 13.92) | 7.36 (－3.05, 17.78) | H+W | － | － | － |
| －2.33 (－8.67, 4.00) | 0.23 (－7.77, 8.22) | －3.16 (－11.57, 5.26) | 1.77 (－4.56, 8.10) | －1.18 (－9.15, 6.80) | 1.73 (－7.02, 10.48) | 5.71 (－2.88, 14.31) | －1.65 (－11.34, 8.04) | I+W | －1.34 (－12.67, 10.00) | 10.56 (2.88, 18.24)a |
| 1.60 (－4.64, 7.83) | 4.16 (－3.76, 12.09) | 0.78 (－7.57, 9.13) | 5.71 (－0.54, 11.95) | 2.75 (－5.16, 10.66) | 5.66 (－3.03, 14.35) | 9.65 (1.11, 18.18)a | 2.28 (－7.35, 11.92) | 3.93 (－3.70, 11.57) | J+W | 11.90 (3.56, 20.23)a |
| 2.43 (－0.80, 5.67) | 5.00 (－0.85, 10.85) | 1.61 (－4.80, 8.03) | 6.54 (3.31, 9.77)a | 3.59 (－2.24, 9.42) | 6.50 (－0.35, 13.36) | 10.48 (3.83, 17.14)a | 3.12 (－4.89, 11.13) | 4.77 (－0.68, 10.22) | 0.84 (－4.51, 6.18) | W |
Table 7 Network Meta-analysis of CRP (lower left) and network Meta-analysis of ESR (upper right)
| A+W | －2.67 (－11.62, 6.28) | －6.18 (－18.05, 5.69) | －6.26 (－12.35, －0.17)a | 0.86 (－12.05, 13.76) | －2.34 (－13.49, 8.81) | －8.47 (－18.93, 1.99) | － | －6.68 (－15.65, 2.30) | －8.02 (－17.56, 1.53) | 3.88 (－0.76, 8.52) |
|---|---|---|---|---|---|---|---|---|---|---|
| －2.56 (－9.24, 4.11) | B+W | －3.51 (－16.88, 9.85) | －3.59 (－12.22, 5.04) | 3.53 (－10.74, 17.80) | 0.33 (－12.37, 13.03) | －5.80 (－17.89, 6.29) | － | －4.01 (－14.86, 6.84) | －5.35 (－16.66, 5.97) | 6.55 (－1.11, 14.21) |
| 0.82 (－6.37, 8.01) | 3.38 (－5.30, 12.07) | C+W | －0.08 (－11.70, 11.54) | 7.04 (－9.23, 23.31) | 3.84 (－11.09, 18.77) | －2.29 (－16.72, 12.14) | － | －0.50 (－13.86, 12.87) | －1.84 (－15.60, 11.93) | 10.06 (－0.88, 21.01) |
| －4.11 (－8.65, 0.43) | －1.54 (－8.22, 5.13) | －4.93 (－12.14, 2.28) | D+W | 7.12 (－5.56, 19.80) | 3.92 (－6.97, 14.81) | －2.21 (－12.39, 7.98) | － | －0.42 (－9.06, 8.22) | －1.76 (－10.99, 7.48) | 10.14 (6.17, 14.11)a |
| －1.16 (－7.80, 5.49) | 1.41 (－6.84, 9.66) | －1.98 (－10.66, 6.71) | 2.95 (－3.67, 9.57) | E+W | －3.20 (－18.94, 12.54) | －9.33 (－24.58, 5.93) | － | －7.54 (－21.82, 6.75) | －8.87 (－23.52, 5.77) | 3.02 (－9.02, 15.06) |
| －4.07 (－11.60, 3.46) | －1.50 (－10.49, 7.49) | －4.89 (－14.33, 4.56) | 0.04 (－7.41, 7.50) | －2.91 (－11.83, 6.00) | F+W | －6.13 (－19.92, 7.66) | － | －4.34 (－17.06, 8.38) | －5.68(－18.79, 7.44) | 6.22 (－3.91, 16.35) |
| －8.05 (－15.42, －0.68)a | －5.48 (－14.33, 3.36) | －8.87 (－18.14, 0.40) | －3.94 (－11.27, 3.39) | －6.89 (－15.69, 1.90) | －3.98 (－13.40, 5.44) | G+W | － | 1.79 (－10.33, 13.91) | 0.45 (－12.08, 12.99) | 12.35 (2.98, 21.72)a |
| －0.69 (－9.33, 7.95) | 1.88 (－8.04, 11.80) | －1.51 (－11.77, 8.76) | 3.42 (－5.22, 12.06) | 0.47 (－9.44, 10.38) | 3.38 (－7.16, 13.92) | 7.36 (－3.05, 17.78) | H+W | － | － | － |
| －2.33 (－8.67, 4.00) | 0.23 (－7.77, 8.22) | －3.16 (－11.57, 5.26) | 1.77 (－4.56, 8.10) | －1.18 (－9.15, 6.80) | 1.73 (－7.02, 10.48) | 5.71 (－2.88, 14.31) | －1.65 (－11.34, 8.04) | I+W | －1.34 (－12.67, 10.00) | 10.56 (2.88, 18.24)a |
| 1.60 (－4.64, 7.83) | 4.16 (－3.76, 12.09) | 0.78 (－7.57, 9.13) | 5.71 (－0.54, 11.95) | 2.75 (－5.16, 10.66) | 5.66 (－3.03, 14.35) | 9.65 (1.11, 18.18)a | 2.28 (－7.35, 11.92) | 3.93 (－3.70, 11.57) | J+W | 11.90 (3.56, 20.23)a |
| 2.43 (－0.80, 5.67) | 5.00 (－0.85, 10.85) | 1.61 (－4.80, 8.03) | 6.54 (3.31, 9.77)a | 3.59 (－2.24, 9.42) | 6.50 (－0.35, 13.36) | 10.48 (3.83, 17.14)a | 3.12 (－4.89, 11.13) | 4.77 (－0.68, 10.22) | 0.84 (－4.51, 6.18) | W |
Table 8 SUCRA values for each intervention
| Treatment | Total effective rate | Incidence of adverse reactions | CRP | ESR |
|---|---|---|---|---|
| A+W | 30.6 | 85.7a | 36.7 | 27.0 |
| B+W | 62.2 | 27.2 | 59.8 | 43.5 |
| C+W | 78.2 | 20.8 | 31.6 | 63.2 |
| D+W | 52.8 | 66.4 | 74.7 | 67.4 |
| E+W | 49.7 | － | 47.8 | 28.4 |
| F+W | 57.8 | 33.4 | 71.1 | 43.3 |
| G+W | 27.8 | － | 92.8a | 76.8a |
| H+W | 82.8b | 73.9 | 42.8 | - |
| I+W | 54.2 | 81.2 | 57.8 | 68.4 |
| J+W | 52.5 | 36.1 | 22.4 | 75.4 |
| W | 1.4 | 25.6 | 12.5 | 6.6 |
Table 8 SUCRA values for each intervention
| Treatment | Total effective rate | Incidence of adverse reactions | CRP | ESR |
|---|---|---|---|---|
| A+W | 30.6 | 85.7a | 36.7 | 27.0 |
| B+W | 62.2 | 27.2 | 59.8 | 43.5 |
| C+W | 78.2 | 20.8 | 31.6 | 63.2 |
| D+W | 52.8 | 66.4 | 74.7 | 67.4 |
| E+W | 49.7 | － | 47.8 | 28.4 |
| F+W | 57.8 | 33.4 | 71.1 | 43.3 |
| G+W | 27.8 | － | 92.8a | 76.8a |
| H+W | 82.8b | 73.9 | 42.8 | - |
| I+W | 54.2 | 81.2 | 57.8 | 68.4 |
| J+W | 52.5 | 36.1 | 22.4 | 75.4 |
| W | 1.4 | 25.6 | 12.5 | 6.6 |
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